Comparison of outcomes between patients with alcoholic cirrhosis and those with hepatitis C virus‐related cirrhosis

Toshikuni, Nobuyuki; Izumi, Akiyoshi; Nishino, Ken; Inada, Nobu; Sakanoue, Ritsuko; Yamato, Ryumei; Suehiro, Mitsuhiko; Kawanaka, Miwa; Yamada, Gotaro

doi:10.1111/j.1440-1746.2009.05851.x

Cited by 77 publications

(64 citation statements)

References 25 publications

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“…Although the risk of HCC development was lower in alcoholic cirrhosis than in hepatitis C virus-related cirrhosis [27], the combination of alcohol and viral hepatitis results in a more rapid progression of liver disease [28]. An HCC that develops in the presence of chronic liver disease with underlying alcoholic aetiology may have a different clinical course.…”

Section: Discussionmentioning

confidence: 98%

Prediction of microvascular invasion of hepatocellular carcinoma by pre-operative CT imaging

Rc²,

Cw³

et al. 2012

BJR

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Objective: The aim of this study was to diagnose microvascular invasion in patients with solitary hepatocellular carcinoma (HCC) from pre-operative CT imaging. Methods: 102 patients with solitary HCC who underwent curative hepatectomy were retrospectively included in our study. The pre-operative 3-phase CT imaging and laboratory data for the 102 patients were reviewed. Tumour size, tumour margin, peritumoral enhancement and a-fetoprotein level were assessed. Surgical pathology was reviewed; tumour differentiation, liver fibrosis score and microvascular invasion were recorded. Results: The histopathological results revealed that 50 HCCs were positive and the other 52 were negative for microvascular invasion. Univariate analysis revealed that tumour size (p50.036), higher Edmondson-Steiner grade (p50.047) and non-smooth tumour margin (p,0.001) showed statistically significant associations with microvascular invasion. Multivariate logistic regression analysis showed that non-smooth tumour margin had a statistically significant association with microvascular invasion only (p,0.001). The sensitivity, specificity, positive predictive value and negative predictive value of the non-smooth tumour margin in the prediction of microvascular invasion were 66%, 86.5%, 82.5% and 72.6%, respectively. Conclusion: Non-smooth tumour margin in pre-operative CT had a statistically significant association with microvascular invasion. More aggressive treatment should be considered in HCC patients with suspected positive microvascular invasion. Hepatic resection is a potentially curative treatment modality for patients with hepatocellular carcinoma (HCC) [1][2][3][4]. Histopathological vascular tumour invasion is a well-known major prognostic factor for patients with HCC who have undergone hepatic resection or liver transplantation [5][6][7][8]. Iwatsuki et al [9] reported that microvascular and macrovascular invasions were associated with a 4.4-and 15-fold increased risk of recurrence, respectively, for patients who had undergone liver transplantation. Because microvascular tumour invasion has a significant impact on recurrence and prognosis, preoperative diagnosis of microvascular invasion is needed.Radiological detection of microvascular tumour invasion may facilitate the pre-operative prediction of a patient's prognosis. Many researchers have tried to elucidate microvascular invasion based on pre-operative imaging studies, including CT during hepatic angiography, dynamic MRI and superparamagnetic iron oxideenhanced MRI [10][11][12][13]. However, radiological findings suggestive of microvascular invasion in pre-operative CT have not yet been well established. The purpose of our study was to diagnose microvascular invasion in patients with solitary HCC from pre-operative triphasic CT findings. Methods and materials PatientsApproval for retrospective study was obtained from our institutional review board. Between January 2007 and December 2009, 153 patients with HCC who underwent elective curative hepatectomy in our institution were...

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Section: Discussionmentioning

confidence: 98%

Prediction of microvascular invasion of hepatocellular carcinoma by pre-operative CT imaging

Rc²,

Cw³

et al. 2012

BJR

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“…It has been suggested-with some controversy-that the etiology of the underlying liver disease, eg, HBV versus HCV, may affect Cancer the effectiveness of sorafenib. [10][11][12][13] The differences in median PFS and OS between the SHARP trial (5.5 months and 10.7 months) and the Asia-Pacific trial (2.8 months [TTP] and 6.5 months) have been considered to be due at least partially to the difference in HBV status (20% vs 70%). Forty percent of patients in our study had HBV infection (including 11 patients with HBV only and 5 patients with both HBV and HCV).…”

Section: Discussionmentioning

confidence: 99%

Phase 2 trial of bevacizumab, capecitabine, and oxaliplatin in treatment of advanced hepatocellular carcinoma

Sun

Sohal

Haller

et al. 2011

Cancer

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BACKGROUND: Anti‐angiogenesis agents have shown effectiveness in treatment of hepatocellular carcinoma (HCC). It is important to investigate more effective and safe systemic treatment options for patients with advanced HCC. This phase 2 study was designed to determine the efficacy and toxicity of the combination of bevacizumab, capecitabine, and oxaliplatin in patients with advanced unresectable and untransplantable HCC. METHODS: Chemotherapy‐naive patients with advanced unresectable and untransplantable HCC were treated with bevacizumab 5 mg/kg and oxaliplatin 130 mg/m2 on day 1 of each cycle, and capecitabine 825 mg/m2 orally twice a day from days 1 to 14 of a 21‐day cycle. RESULTS: Forty patients were enrolled to the study, in which 40% had Child‐Pugh B disease. Forty percent had an Eastern Cooperative Oncology Group performance status (PS) of 0, 55% had PS of 1, and 5% had PS of 2. Forty percent of patients had hepatitis B virus infection. The median progression‐free survival was 6.8 months (95% CI, 3.4‐9.1 months), and the median overall survival was 9.8 months (95% CI, 5.2‐12.1 months). Eight patients (20%) achieved partial response; 23 patients had stable disease with overall 77.5% disease control rate. The combination was tolerable with limited grade 3/4 toxicity, mainly peripheral neurotoxicity and fatigue. CONCLUSIONS: The combination appeared effective and safe, and the results were encouraging. Further investigation should be considered. Cancer 2011. © 2011 American Cancer Society.

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“…3,4 In addition, a number of reports have charted the natural history of compensated cirrhosis due to chronic HCV infection and have documented the higher frequency of HCC in patients with HCV-related cirrhosis compared with cirrhosis associated with other aetiologies, in particular, alcohol. 5,6 However, the rate at which complications of cirrhosis from chronic HCV infection develop remains unclear and here we report the results of a systematic review of studies published over the last 14 years that have examined the development of decompensation.…”

Section: Aliment Pharmacol Ther 2010; 32: 344-355mentioning

confidence: 99%

“…Two prospective 16,17 and one retrospective study 8 compared the outcome of patients with HBV and HCV cirrhosis, and one prospective study compared outcome of patients with HCV and alcohol-related cirrhosis. 6 Only the data pertaining to patients with HCV cirrhosis are included in Table 1. A majority (eight) of investigations were conducted in Western Europe, one was performed in the USA 18 and four in Japan.…”

Section: -11mentioning

confidence: 99%

“…A majority (eight) of investigations were conducted in Western Europe, one was performed in the USA 18 and four in Japan. 6,12,15,16 The number of participants was variable (median 144 patients), ranging from 55 (in the S Sy ys st te em ma at ti ic c r re ev vi ie ew w: : o ou ut tc co om me e o of f c co om mp pe en ns sa at te ed d H HC CV V c ci ir rr rh ho os si is s The outcomes assessed were reasonably uniform, with most studies evaluating rates of death, development of HCC and decompensation of cirrhosis (including development of jaundice, ascites, variceal haemorrhage or hepatic encephalopathy). Two studies were designed to investigate the effect of interferon on development of HCC and so did not report data for other outcomes.…”

Section: -11mentioning

confidence: 99%

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Systematic review: outcome of compensated cirrhosis due to chronic hepatitis C infection

Alazawi

Cunningham

Dearden

et al. 2010

Aliment Pharmacol Ther

175

121

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Comparison of outcomes between patients with alcoholic cirrhosis and those with hepatitis C virus‐related cirrhosis

Cited by 77 publications

References 25 publications

Prediction of microvascular invasion of hepatocellular carcinoma by pre-operative CT imaging

Prediction of microvascular invasion of hepatocellular carcinoma by pre-operative CT imaging

Phase 2 trial of bevacizumab, capecitabine, and oxaliplatin in treatment of advanced hepatocellular carcinoma

Systematic review: outcome of compensated cirrhosis due to chronic hepatitis C infection

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