Risk of hepatocellular carcinoma and extrahepatic malignancies in primary biliary cirrhosis.
OBJECTIVE
In primary biliary cirrhosis (PBC), the development of hepatocellular carcinoma (HCC) was thought to represent a rare complication. In contrast, extrahepatic malignancies have been reported to be significantly associated with PBC. The aim of this study was to determine the incidence of HCC and of extrahepatic malignancies in a large cohort of patients with PBC.


METHODS
A total of 212 patients with documented PBC (19 men and 193 women) were followed up for a median of 6 (range, 1-23) years.


RESULTS
In total, 23 (10.8%) cases of malignancy were diagnosed; eight (3.8%) patients with HCC and 15 (7.0%) with extrahepatic malignancies. PBC patients were found to have a 10-year risk of 4% for developing HCC and of 13% for developing extrahepatic malignancies. The risk for HCC was significantly higher in the PBC patients with cirrhosis (15% at 10 years of follow-up). In contrast, the histologic stage of PBC does not influence the risk for extrahepatic malignancy.


CONCLUSIONS
Our study confirms that there is a risk of HCC in Greek patients with PBC, particularly in patients with stage IV PBC. The risk of extrahepatic malignancies is higher than that of HCC, but it is not influenced by the histologic stage of the liver disease.
Deutsch
Melanie
M
Academic Department of Internal Medicine Hippocration General Hospital, Athens, Greece.
Papatheodoridis
George V
GV
Tzakou
Anastasia
A
Hadziyannis
Stephanos J
SJ
D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000209:etiology; D006528:Carcinoma, Hepatocellular / Q000453:epidemiology / Q000209:etiology* / Q000473:pathology; D015331:Cohort Studies; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D005833:Genital Neoplasms, Female / Q000209:etiology; D006115:Greece / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008105:Liver Cirrhosis, Biliary / Q000150:complications* / Q000453:epidemiology / Q000473:pathology; D008113:Liver Neoplasms / Q000453:epidemiology / Q000209:etiology* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors