title: Hepatocellular carcinoma in Japanese patients with nonalcoholic fatty liver disease and alcoholic liver disease: multicenter survey.
abstract: BACKGROUND
  In Japan, the prevalence of hepatocellular carcinoma (HCC) associated with nonviral liver disease, especially with nonalcoholic fatty liver disease (NAFLD-HCC) and alcoholic liver disease (ALD-HCC), has been increasing. Clarification of the clinical features of NAFLD-HCC and ALD-HCC is needed. We performed a large retrospective multicenter survey to clarify the clinical course of these two types of HCC.
  
  
  METHODS
  Clinical characteristics, survival, and recurrence were examined in 532 patients with ALD-HCC and 209 patients with NAFLD-HCC who were diagnosed between January 2000 and December 2013.
  
  
  RESULTS
  The ALD-HCC patients were predominantly male and were younger than the patients with NAFLD-HCC. Lifestyle-related diseases were significantly more common in the NAFLD-HCC group, but the prevalence of cirrhosis was significantly higher in the ALD-HCC group. The histological diagnosis of NAFLD-HCC showed a gender difference (F4; 72.7 % in the females vs. 37.6 % in the males). The characteristic features of HCC including histology, survival rate, and recurrence rate were quite similar in the NAFLD-HCC and ALD-HCC groups: 5-year survival rates 49.1 vs. 43.7 %; 5-year recurrence rates 69.6 vs. 65.4 %, respectively. However, the risk factors for recurrence differed between the two groups: des-gamma-carboxy prothrombin was a risk factor in NAFLD-HCC and α-fetoprotein was a risk factor in ALD-HCC.
  
  
  CONCLUSIONS
  Although the characteristic features underlying these two diseases are different, the two HCC groups showed a similar clinical course. The recurrence rates of the two HCC groups were relatively high. We found that critical tumor markers for recurrence differed between the two diseases.
authors.affiliation: Department of Internal Medicine and Gastroenterology, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan. ktoku@pg7.so-net.ne.jp.
authors.forename: Katsutoshi
authors.initials: K
authors.lastname: Tokushige
authors.affiliation: Department of Gastroenterology and Metabolism, Hiroshima University, Hiroshima, Japan.
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Hyogo
authors.affiliation: Department of Hepatology, Sapporo Kosei General Hospital, Hokkaido, Japan.
authors.forename: Tomoaki
authors.initials: T
authors.lastname: Nakajima
authors.affiliation: Department of Gastroenterology and Hepatology, Kochi Medical School, Kochi, Japan.
authors.forename: Masafumi
authors.initials: M
authors.lastname: Ono
authors.affiliation: Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Fukuoka, Japan.
authors.forename: Takumi
authors.initials: T
authors.lastname: Kawaguchi
authors.affiliation: Department of Gastroenterology, Faculty of Medicine, Oita University, Oita, Japan.
authors.forename: Koichi
authors.initials: K
authors.lastname: Honda
authors.affiliation: Division of Hepatology, Liver Center, Saga Medical School, Saga, Japan.
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Eguchi
authors.affiliation: Department of Gastroenterology, National Center for Global Health and Medicine, Tokyo, Japan.
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Nozaki
authors.affiliation: General Internal Medicine 2, Kawasaki Hospital, Kawasaki Medical School, Okayama, Japan.
authors.forename: Miwa
authors.initials: M
authors.lastname: Kawanaka
authors.affiliation: Center for Digestive and Liver Diseases, Nara City Hospital, Nara, Japan.
authors.forename: Saiyu
authors.initials: S
authors.lastname: Tanaka
authors.affiliation: Department of Gastroenterology and Hepatology, Yokohama City University School of Medicine, Yokohama, Kanagawa, Japan.
authors.forename: Kento
authors.initials: K
authors.lastname: Imajo
authors.affiliation: Department of Gastroenterology and Hepatology, Kyoto Prefectural University of Medicine, Kyoto, Japan.
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Sumida
authors.affiliation: Department of Gastroenterology and Hepatology, Osaka University, Graduate School of Medicine, Osaka, Japan.
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Kamada
authors.affiliation: Department of Gastroenterology, Osaka City Juso Hospital, Osaka, Japan.
authors.forename: Hideki
authors.initials: H
authors.lastname: Fujii
authors.affiliation: Department of Gastroenterology, Nayoro City General Hospital, Hokkaido, Japan.
authors.forename: Yasuaki
authors.initials: Y
authors.lastname: Suzuki
authors.affiliation: Department of Internal Medicine and Gastroenterology, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan.
authors.forename: Tomomi
authors.initials: T
authors.lastname: Kogiso
authors.affiliation: Department of Hepatology, Sapporo Kosei General Hospital, Hokkaido, Japan.
authors.forename: Yoshiyasu
authors.initials: Y
authors.lastname: Karino
authors.affiliation: Department of Gastroenterology and Hepatology, Kochi Medical School, Kochi, Japan.
authors.forename: Kensuke
authors.initials: K
authors.lastname: Munekage
authors.affiliation: Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Fukuoka, Japan.
authors.forename: Ryoko
authors.initials: R
authors.lastname: Kuromatsu
authors.affiliation: Division of Hepatology, Liver Center, Saga Medical School, Saga, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Oeda
authors.affiliation: Department of Gastroenterology, National Center for Global Health and Medicine, Tokyo, Japan.
authors.forename: Mikio
authors.initials: M
authors.lastname: Yanase
authors.affiliation: Center for Digestive and Liver Diseases, Nara City Hospital, Nara, Japan.
authors.forename: Kohjiro
authors.initials: K
authors.lastname: Mori
authors.affiliation: Department of Gastroenterology and Hepatology, Yokohama City University School of Medicine, Yokohama, Kanagawa, Japan.
authors.forename: Yuji
authors.initials: Y
authors.lastname: Ogawa
authors.affiliation: Department of Gastroenterology and Hepatology, Kyoto Prefectural University of Medicine, Kyoto, Japan.
authors.forename: Yuya
authors.initials: Y
authors.lastname: Seko
authors.affiliation: Department of Gastroenterology and Hepatology, Osaka University, Graduate School of Medicine, Osaka, Japan.
authors.forename: Tetsuo
authors.initials: T
authors.lastname: Takehara
authors.affiliation: Department of Gastroenterology and Hepatology, Kyoto Prefectural University of Medicine, Kyoto, Japan.
authors.forename: Yoshito
authors.initials: Y
authors.lastname: Itoh
authors.affiliation: Department of Gastroenterology and Hepatology, Yokohama City University School of Medicine, Yokohama, Kanagawa, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Nakajima
authors.affiliation: Center for Digestive and Liver Diseases, Nara City Hospital, Nara, Japan.
authors.forename: Kazuyuki
authors.initials: K
authors.lastname: Kanemasa
authors.affiliation: General Internal Medicine 2, Kawasaki Hospital, Kawasaki Medical School, Okayama, Japan.
authors.forename: Ken
authors.initials: K
authors.lastname: Nishino
authors.affiliation: Department of Gastroenterology, National Center for Global Health and Medicine, Tokyo, Japan.
authors.forename: Naohiko
authors.initials: N
authors.lastname: Masaki
authors.affiliation: Division of Hepatology, Liver Center, Saga Medical School, Saga, Japan.
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Takahashi
authors.affiliation: Department of Gastroenterology, Faculty of Medicine, Oita University, Oita, Japan.
authors.forename: Masataka
authors.initials: M
authors.lastname: Seike
authors.affiliation: Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Fukuoka, Japan.
authors.forename: Takuji
authors.initials: T
authors.lastname: Torimura
authors.affiliation: Department of Gastroenterology and Hepatology, Kochi Medical School, Kochi, Japan.
authors.forename: Toshiji
authors.initials: T
authors.lastname: Saibara
authors.affiliation: Department of Hepatology, Sapporo Kosei General Hospital, Hokkaido, Japan.
authors.forename: Joji
authors.initials: J
authors.lastname: Toyota
authors.affiliation: Department of Gastroenterology and Metabolism, Hiroshima University, Hiroshima, Japan.
authors.forename: Kazuaki
authors.initials: K
authors.lastname: Chayama
authors.affiliation: Department of Internal Medicine and Gastroenterology, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan.
authors.forename: Etsuko
authors.initials: E
authors.lastname: Hashimoto
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000453:epidemiology*; D005260:Female; D006801:Humans; D007564:Japan; D008108:Liver Diseases, Alcoholic / Q000150:complications* / Q000401:mortality / Q000473:pathology; D008113:Liver Neoplasms / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D065626:Non-alcoholic Fatty Liver Disease / Q000150:complications* / Q000401:mortality / Q000473:pathology; D012008:Recurrence; D012189:Retrospective Studies; D015996:Survival Rate
keywords: Alcoholic liver disease; Hepatocellular carcinoma; Nonalcoholic fatty liver disease; Recurrence; Survival