Hepatitis B vs. hepatitis C infection on viral hepatitis-associated hepatocellular carcinoma.
BACKGROUND
To determine clinical-pathologic variables in patients with a new diagnosis of hepatocellular carcinoma (HCC) and underlying hepatitis B vs. C infection.


METHODS
Patients presenting to a single urban hospital with a new diagnosis of HCC were entered into a clinical database. Variables including number and size of tumors, presence of metastases, serum alpha-Fetoprotein, hepatitis serologies, severity of hepatic dysfunction, and presence of cirrhosis were evaluated in 127 patients.


RESULTS
Patients with hepatitis B (HBV) were more likely to develop HCC at a younger age than patients with hepatitis C (HCV) (HBV-26% under age 40, HCV-0% under age 40; p < 0.001), with greater serum alpha-Fetoprotein production (median level: HBV-1000 ng/ml vs. HCV-37 ng/ml; p = 0.002), with larger tumors (HBV-78% >5 cm, HCV-28% >5 cm; p < 0.001), in the absence of cirrhosis (HBV-40%, HCV-0%; p < 0.001), and a decreased eligibility for curative treatment (HBV-14%, HCV-34%; p < 0.05). Conversely, patients with HCV were more likely to develop HCC in association with multiple co-morbidities, cirrhosis, and older age.


CONCLUSIONS
Significant clinical-pathologic differences exist among HCC patients with underlying HBV vs. HCV. These differences impact eligibility for potentially-curative therapy and prognosis.
Department of Surgery, Mount Sinai School of Medicine, New York, USA. spiros.hiotis@mountsinai.org
Spiros P
SP
Hiotis
Nuh N
NN
Rahbari
Gerald A
GA
Villanueva
Eunjie
E
Klegar
Wei
W
Luan
Qin
Q
Wang
Herman T
HT
Yee
D000328:Adult; D000367:Age Factors; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis / Q000503:physiopathology* / Q000821:virology*; D015897:Comorbidity; D005260:Female; D006509:Hepatitis B / Q000150:complications*; D006526:Hepatitis C / Q000150:complications*; D006801:Humans; D008099:Liver / Q000503:physiopathology; D008103:Liver Cirrhosis / Q000453:epidemiology; D008113:Liver Neoplasms / Q000175:diagnosis / Q000503:physiopathology* / Q000821:virology*; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D015995:Prevalence; D011379:Prognosis; D000509:alpha-Fetoproteins / Q000378:metabolism
D000509:alpha-Fetoproteins