Effect of the etiology of viral cirrhosis on the survival of patients with hepatocellular carcinoma.
OBJECTIVE
The aim of this study was to assess whether hepatocellular carcinoma occurring in the setting of hepatitis B or C virus infection has different prognosis.


METHODS
We performed a multicentric case-control study comparing 102 pairs of patients affected by hepatitis B virus- or hepatitis C virus-related hepatocellular carcinoma. Patients were matched for sex (male/female: 84/18 pairs), age, center, and period of enrollment, underlying chronic liver disease (cirrhosis/chronic hepatitis: 97/5 pairs), Child-Pugh class (A/B/C: 70/25/7 pairs), hepatocellular carcinoma stage (nonadvanced/advanced: 50/52 pairs) and, when possible, modality of cancer diagnosis (75 pairs: 47 during and 28 outside surveillance).


RESULTS
In the whole population, patients with hepatitis B tended to have a poor prognosis than those with hepatitis C (p = 0.160), and this difference became statistically significant among the patients with an advanced hepatocellular carcinoma (p = 0.025). Etiology, Child-Pugh class, gross pathology, and alpha-fetoprotein were the significant independent prognostic factors in the whole population. The distribution of these prognostic factors did not differ between patients with hepatitis B or hepatitis C, both in the whole population and in the subgroup of advanced hepatocellular carcinomas.


CONCLUSIONS
Hepatitis B virus-related hepatocellular carcinomas have a greater aggressiveness than hepatitis C virus-related tumors, which becomes clinically manifest once they have reached an advanced stage.
Cantarini
Maria Chiara
MC
Dipartimento di Medicina Interna, Cardioangiologia, Epatologia, Alma Mater Studiorum-University of Bologna, Bologna, Italy.
Trevisani
Franco
F
Morselli-Labate
Antonio Maria
AM
Rapaccini
Gianludovico
G
Farinati
Fabio
F
Del Poggio
Paolo
P
Di Nolfo
Maria Anna
MA
Benvegnù
Luisa
L
Zoli
Marco
M
Borzio
Franco
F
Bernardi
Mauro
M
D000367:Age Factors; D006528:Carcinoma, Hepatocellular / Q000401:mortality* / Q000473:pathology / Q000821:virology*; D016022:Case-Control Studies; D016001:Confidence Intervals; D005260:Female; D005500:Follow-Up Studies; D006509:Hepatitis B / Q000150:complications; D006526:Hepatitis C / Q000150:complications; D006801:Humans; D008103:Liver Cirrhosis / Q000401:mortality* / Q000473:pathology / Q000821:virology*; D008111:Liver Function Tests; D008113:Liver Neoplasms / Q000401:mortality* / Q000473:pathology / Q000821:virology*; D008297:Male; D015999:Multivariate Analysis; D016017:Odds Ratio; D011336:Probability; D012016:Reference Values; D018570:Risk Assessment; D012720:Severity of Illness Index; D012737:Sex Factors; D016019:Survival Analysis