title: Hepatic and extrahepatic malignancies in cirrhosis caused by nonalcoholic steatohepatitis and alcoholic liver disease.
abstract: BACKGROUND
  To clarify the carcinogenic factors associated with steatohepatitis, we investigated the characteristic features of hepatic and extrahepatic malignancies in patients with cirrhotic nonalcoholic steatohepatitis (NASH-LC) and cirrhotic alcoholic liver disease (ALD-LC).
  
  
  METHODS
  A total of 72 patients with NASH-LC and 85 with ALD-LC (both biopsy-proven steatohepatitis without hepatocellular carcinoma [HCC]) were assessed with regard to the development of hepatic and extrahepatic malignancies. Risk factors for HCC were analyzed.
  
  
  RESULTS
  During follow-up, 10 NASH-LC patients and 6 ALD-LC patients developed HCC. The 5-year HCC development rate was similar for these 2 groups, being 10.5% in the NASH-LC group and 12.3% in the ALD-LC group. After adjusting for age and gender, the HCC development rates were also similar. Risk factors for HCC in the NASH-LC group were older age, higher γ-GTP level, and higher Child-Pugh score as determined by Cox hazards analysis. Regarding risk factors in the ALD-LC group, no risk factor was found by Cox hazards analysis, although diabetes mellitus led to a significantly higher HCC rate by log-rank test (p = 0.013). Regarding extrahepatic cancer, only 1 NASH-LC patient (1.4%) developed endometrial cancer. In contrast, 7 ALD-LC patients (8.2%) had other cancers (p = 0.052).
  
  
  CONCLUSIONS
  Comparison between NASH-LC and ALD-LC revealed similar HCC development curves. However, the risk factors for HCC and extrahepatic malignancies differed between the 2 diseases. In ALD-LC, the incidences of HCC and extrahepatic cancer are similar. When treating LC patients with NASH or ALD, the risk factors and extrahepatic malignancies associated with ALD-LC should be assessed.
authors: Department of Internal Medicine and Gastroenterology, Tokyo Women's Medical University, Tokyo, Japan.
authors: Kazuhisa
authors: K
authors: Kodama
authors: Katsutoshi
authors: K
authors: Tokushige
authors: Etsuko
authors: E
authors: Hashimoto
authors: Makiko
authors: M
authors: Taniai
authors: Keiko
authors: K
authors: Shiratori
mesh_terms: D000328:Adult; D000368:Aged; D004938:Esophageal Neoplasms / Q000175:diagnosis / Q000453:epidemiology; D005234:Fatty Liver / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008103:Liver Cirrhosis / Q000175:diagnosis / Q000453:epidemiology*; D008108:Liver Diseases, Alcoholic / Q000175:diagnosis / Q000453:epidemiology*; D008113:Liver Neoplasms / Q000175:diagnosis / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D065626:Non-alcoholic Fatty Liver Disease; D010610:Pharyngeal Neoplasms / Q000175:diagnosis / Q000453:epidemiology; D012189:Retrospective Studies