Characteristics of hepatocellular carcinoma in hemodialysis patients in hepatitis B endemic area.
OBJECTIVE
Hepatocellular carcinoma is one of the most common malignancies in Taiwan, a hepatitis B endemic area. In this study, we aimed to evaluate the characteristics of hepatocellular carcinoma in patients receiving hemodialysis, as this patient group is at high risk for malignancy.


METHODS
From October 1991 to September 1997, thirteen patients receiving hemodialysis and diagnosed with hepatocellular carcinoma were enrolled in this retrospective study. Patients' clinical course, laboratory data, image study and treatment were evaluated.


RESULTS
Among these 13 patients, hepatitis B virus related in 6 and hepatitis C virus related in 7. There was no statistical significance in serum levels of asparate aminotransferase, alanine aminotransferase, bilirubin and alpha-fetoprotein between hepatitis B virus and hepatitis C virus related hepatocellular carcinoma. Hepatitis B virus related hepatocellular carcinoma had a shorter mean dialysis period (29.67 +/- 22.18 vs. 87.86 +/- 79.90 months, P = 0.25) and mean duration from beginning hemodialysis to diagnosis of hepatocellular carcinoma (17.16 +/- 26.94 vs. 76.08 +/- 65.69 months, P = 0.05), but there was no statistical significance. In the area of treatment, the survival curves of the treatment (hepatic resection and/or transcatheter arterial chemoembolization) group and supportive group were compared by log-rank test and there was no statistical significance for these two groups (P = 0.69).


CONCLUSIONS
Both hepatitis B virus and hepatitis C virus are equally important for hepatocellular carcinoma in hemodialysis patients in hepatitis B endemic Taiwan. The acquisition of hepatitis B virus or hepatitis C virus might be not related to hemodialysis. Periodic screening with ultrasonography and serum alpha-fetoprotein is necessary among hemodialysis patients with evidence of hepatitis B virus or hepatitis C virus infection.
Division of Gastroenterology, Department of Internal Medicine, Department of Emergency Medicine, Taichung Veterans General Hospital, 160, Sec. 3, Chung-Kang Rd., Taichung, Taiwan 407, R.O.C.
Chun-Fang
CF
Tung
Dar-Yu
DY
Yang
Wei-Hsiung
WH
Hu
Yen-Chun
YC
Peng
Wai-Keung
WK
Chow
Gran-Hum
GH
Chen
D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000097:blood / Q000401:mortality / Q000821:virology; D015897:Comorbidity; D004621:Embolization, Therapeutic; D019353:Endemic Diseases; D005260:Female; D006509:Hepatitis B / Q000453:epidemiology; D006801:Humans; D007676:Kidney Failure, Chronic / Q000453:epidemiology; D008103:Liver Cirrhosis / Q000453:epidemiology; D008113:Liver Neoplasms / Q000097:blood / Q000401:mortality / Q000821:virology; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis; D012189:Retrospective Studies