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Difference in malignancies of chronic liver disease due to non-alcoholic fatty liver disease or hepatitis C in Japanese elderly patients

Authors


  • Guarantor of the article: Yasuji Arase, M.D.

  • Specific author contributions: Yasuji Arase: design, data collection, data analysis, manuscript development and overseeing; Mariko Kobayashi: design, data collection, data analysis, manuscript development; Fumitaka Suzuki, Yoshiyuki Suzuki, Norio Akuta, Norihiro Imai, Hitomi Sezaki, Masahiro Kobayashi, Naoki Matsumoto, Satoshi Saito, Tetsuya Hosaka, Kenji Ikeda: data collection; Yusuke Kawamura, Yuki Ohmoto, Kazuhisa Amakawa, Shiun Dong Hsieh, Kyoko Ogawa, Maho Tanabe, Hirhoshi Tsuji: data collection; Hiromitsu Kumada: design, data collection, data analysis, manuscript development and overseeing; Tetsuro Kobayashi: manuscript development and overseeing.

  • Conflict of interest: None.

  • Financial support: None.

  • Potential competing interests: None.

Dr Yasuji Arase, Department of Hepatology, Toranomon Hospital, 2-2-2, Toranomon, Minato-ku, Tokyo 105-8470, Japan. Email: es9y-ars@asahi-net.or.jp

Abstract

Aim:  Malignancies that include hepatocellular carcinoma often occurred in patients with chronic liver disease. The aim of this retrospective match control study was to assess the cumulative development incidence and predictive factors for total malignancies in elderly Japanese patients with non-alcoholic hepatic diseases (NAFLD) or hepatitis C virus (HCV).

Methods:  A total of 1600 NAFLD patients with age of ≥60 years were enrolled, and 1600 HCV patients with age of ≥60 years were selected as control by matching 1:1 with NAFLD group for age, sex, and follow-up period. The primary goal is the first development of malignancies. Evaluation was performed by the use of the Wilcoxon rank sum test, the Kaplan–Meier method, and Cox proportional hazard model. The mean observation period is 8.2 years in both NAFLD and HCV group, respectively.

Results:  The number of patients with the development of malignancies was 167 in the NAFLD group and 395 in the HCV group. The 10th development rate of malignancies was 13.9% in the NAFLD group and 28.2% in the HCV group (risk ratio 2.27; P < 0.001). The incident rates of hepatocellular carcinoma in all the malignancies were 6.0% (10/167) in the NAFLD group and 67.6% (267/395) in the HCV group (P < 0.001). The malignancies in the NAFLD group were observed in the following order: gastric cancer 34 cases (20.4%) > colon cancer 31 cases (18.6%) > prostate cancer 21 cases (12.6%).

Conclusions:  The incident rates of hepatocellular carcinoma in all the malignancies were approximately 6% in the NAFLD group and two-thirds in the HCV group.

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