title: Difference in malignancies of chronic liver disease due to non-alcoholic fatty liver disease or hepatitis C in Japanese elderly patients.
abstract: OBJECTIVE
  Malignancies that include hepatocellular carcinoma often occurred in patients with chronic liver disease. The aim of this retrospective match control study was to assess the cumulative development incidence and predictive factors for total malignancies in elderly Japanese patients with non-alcoholic hepatic diseases (NAFLD) or hepatitis C virus (HCV).
  
  
  METHODS
  A total of 1600 NAFLD patients with age of ≥60 years were enrolled, and 1600 HCV patients with age of ≥60 years were selected as control by matching 1:1 with NAFLD group for age, sex, and follow-up period. The primary goal is the first development of malignancies. Evaluation was performed by the use of the Wilcoxon rank sum test, the Kaplan-Meier method, and Cox proportional hazard model. The mean observation period is 8.2 years in both NAFLD and HCV group, respectively.
  
  
  RESULTS
  The number of patients with the development of malignancies was 167 in the NAFLD group and 395 in the HCV group. The 10th development rate of malignancies was 13.9% in the NAFLD group and 28.2% in the HCV group (risk ratio 2.27; P < 0.001). The incident rates of hepatocellular carcinoma in all the malignancies were 6.0% (10/167) in the NAFLD group and 67.6% (267/395) in the HCV group (P < 0.001). The malignancies in the NAFLD group were observed in the following order: gastric cancer 34 cases (20.4%) > colon cancer 31 cases (18.6%) > prostate cancer 21 cases (12.6%).
  
  
  CONCLUSIONS
  The incident rates of hepatocellular carcinoma in all the malignancies were approximately 6% in the NAFLD group and two-thirds in the HCV group.
authors.affiliation: Department of Hepatology and Okinaka Memorial Institute for Medical Research, Toranomon Hospital             Department of Health Management Center, Toranomon Hospital, Tokyo             Department of Third Internal Medicine (Metabolism), University of Yamanashi, Yamanashi, Japan.
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authors.forename: Fumitaka
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authors.lastname: Suzuki
authors.forename: Yoshiyuki
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authors.lastname: Suzuki
authors.forename: Yusuke
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authors.lastname: Kawamura
authors.forename: Norio
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authors.forename: Hiromitsu
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authors.lastname: Kumada
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authors.lastname: Ohmoto
authors.forename: Kazuhisa
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authors.forename: Shiun Dong
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authors.forename: Tetsuro
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authors.lastname: Kobayashi