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Dr. Cavazza was the recipient of an Erasmus Grant during her last year in medical school, carried out at the Liver Unit, Hospital Clínic, University of Barcelona.
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Autoimmune, Cholestatic and Biliary Disease
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Incidence, risk factors, and survival of hepatocellular carcinoma in primary biliary cirrhosis: Comparative analysis from two centers†
Article first published online: 29 MAY 2009
DOI: 10.1002/hep.23095
Copyright © 2009 American Association for the Study of Liver Diseases
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How to Cite
Cavazza, A., Caballería, L., Floreani, A., Farinati, F., Bruguera, M., Caroli, D. and Parés, A. (2009), Incidence, risk factors, and survival of hepatocellular carcinoma in primary biliary cirrhosis: Comparative analysis from two centers. Hepatology, 50: 1162–1168. doi: 10.1002/hep.23095
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Potential conflict of interest: Nothing to report.
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Dr. Cavazza was the recipient of an Erasmus Grant during her last year in medical school, carried out at the Liver Unit, Hospital Clínic, University of Barcelona.
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Publication History
- Issue published online: 28 SEP 2009
- Article first published online: 29 MAY 2009
- Accepted manuscript online: 29 MAY 2009 12:00AM EST
- Manuscript Accepted: 18 MAY 2009
- Manuscript Received: 4 FEB 2009
Funded by
- CIBEREHD, Instituto de Salud Carlos III, Spain
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Abstract
The limited information and divergent results on the prevalence, incidence, and risk factors for hepatocellular carcinoma (HCC) in patients with primary biliary cirrhosis (PBC) may be due to the low prevalence of the disease and geographical and environmental differences. Therefore, we analyzed the incidence, prevalence, survival, and risk factors for HCC in patients with PBC from two European centers (389 from Barcelona, Spain, and 327 from Padova, Italy) followed up for 9.3 ± 6.5 years. Gender, age, smoking habit, alcohol consumption, presence of hepatitis B surface antigen (HBsAg) or hepatitis C virus antibodies (anti-HCV), and advanced histological stage (III-IV) were evaluated as risk factors for tumor development. Twenty-four patients (13 from Barcelona and 11 from Padova) developed HCC. The prevalence of HCC was similar in Barcelona (3.34%) and Padova (3.36%). The incidence was 0.35 and 0.37 per 100 patient-years, respectively. Male gender, age >52 years, smoking habit, alcohol >40 g/day, HBsAg, and anti-HCV were not associated with HCC. Advanced histological stage was the only factor associated with the development of HCC (odds ratio [OR]: 5.80, 95% confidence interval [CI]: 2.34-14.38, P < 0.001). When analyzing the two series separately, male gender was associated with higher likelihood of HCC in Padova (OR: 8.09, 95% CI: 1.93-33.8, P < 0.01). The median survival after the diagnosis of HCC was 36 months. Conclusion: The prevalence and incidence of HCC is similar in Spain and Italy and the advanced histological stage is the only risk factor associated with the development of HCC in PBC. The slight disparities observed between the two series might be explained by patient features on diagnosis of liver disease. (HEPATOLOGY 2009.)