Both authors contributed equally to this study.
Should cirrhosis change our attitude towards treating non-hepatic cancer?
Article first published online: 30 AUG 2011
© 2011 John Wiley & Sons A/S
Volume 32, Issue 1, pages 21–27, January 2012
How to Cite
Cabibbo, G., Palmeri, L., Palmeri, S. and Craxì, A. (2012), Should cirrhosis change our attitude towards treating non-hepatic cancer?. Liver International, 32: 21–27. doi: 10.1111/j.1478-3231.2011.02629.x
- Issue published online: 7 DEC 2011
- Article first published online: 30 AUG 2011
- Manuscript Accepted: 28 JUL 2011
- Manuscript Received: 26 DEC 2010
- non-hepatic cancer
Cirrhosis is a major cause of morbidity and mortality and is the end stage of any chronic liver disease. Cancer, a leading cause of death worldwide, is a growing global health issue. There are limited data in the literature on the incidence, prevalence and management of non-hepatic cancers (NHC) in cirrhotic patients. The aim of this brief review was to underline the main concerns, pitfalls and warnings regarding practice for these patients.
Survival of patients with compensated cirrhosis is significantly longer than that of decompensated cirrhosis and patients with NHC and in Child-Pugh class C should not be candidates for cytotoxic chemotherapy. It is important before starting cytotoxic chemotherapy to assess the aetiology and stage of liver disease and to screen these patients for portal hypertension and fluid retention. During cytotoxic chemotherapy, the effectiveness of cancer treatment, as well the appearance of early signs of hepatic decompensation, must be thoroughly monitored. Future phase 3 trial designs in oncology should include a share of patients with compensated cirrhosis to obtain specific information in this setting. Identification of tests able to measure the global degree of hepatic impairment caused by cirrhosis could help in the management of this particular clinical situation.