Men with biopsy‐confirmed hepatocellular adenoma have a high risk of progression to hepatocellular carcinoma: A nationwide population‐based study

Bossen, Lars; Grønbæk, Henning; Eriksen, Peter Lykke; Jepsen, Peter

doi:10.1111/liv.13423

Cited by 26 publications

(32 citation statements)

References 17 publications

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“…The paper by Bossen et al. provides us with valuable information regarding the epidemiology of hepatocellular adenomas and confirms that males with hepatocellular adenomas are at greater risk of malignant transformation, as compared to women with hepatocellular adenoma. With the recent advances in the field of hepatocellular adenoma subtypes, such as the new sh‐HCA and the discovery that malignant transformation of hepatocellular adenomas is seen mostly in B‐HCA with exon 3 mutations and rarely in those with exon 7/8 mutations, we are moving more and more towards subtype‐based management decisions in addition to the clinical characteristics of sex and size of the tumor.…”

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confidence: 78%

“…12 Epidemiological data of hepatocellular adenoma are severely outdated; the annual incidence rate was last described in 1979 and estimated at 3-4 per 100,000 population per year for long-term oral contraceptive users, compared to 0.1 per 100,000 per year for others. 13 In the current issue of Liver International, Bossen et al 14…”

Section: Malignant Potential Of Hepatocellular Adenomamentioning

confidence: 99%

“…In the study executed by Bossen et al. the overall risk of malignant transformation was 5.8%. They followed 47 females and 5 males for a total of 310.5 years (median follow‐up of 4.7 years per patient).…”

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confidence: 92%

“…In the current issue of Liver International, Bossen et al. have performed an interesting nationwide registry‐based cohort study in Denmark to investigate the incidence of hepatocellular adenoma and the prognosis of adenoma patients, comparing them to random age‐ and gender‐matched controls. They included all patients with histologically verified hepatocellular adenoma diagnosed between 1997 and 2012.…”

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confidence: 99%

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Malignant potential of hepatocellular adenoma

Klompenhouwer

IJzermans

2017

Liver International

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confidence: 78%

Section: Malignant Potential Of Hepatocellular Adenomamentioning

confidence: 99%

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confidence: 92%

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confidence: 99%

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Malignant potential of hepatocellular adenoma

Klompenhouwer

IJzermans

2017

Liver International

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“…Main complications are (potentially lethal) haemorrhage (15‐20%) and malignant transformation to hepatocellular carcinoma (HCC) (5%) . HCA of ≥50 mm size are especially at risk for these complications …”

Section: Introductionmentioning

confidence: 99%

The effect of oral contraceptive pill cessation on hepatocellular adenoma diameter: A retrospective cohort study

Haring

Gouw

Haas

et al. 2019

Liver International

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Background & Aims Hepatocellular adenomas (HCA) are rare, hormone‐driven, benign liver tumours. HCA >50 mm are associated with haemorrhage and malignant transformation. Guidelines recommend cessation of oral contraceptive pills (OCP) for size reduction; however, it is currently unknown how HCA respond to cessation of OCP. We sought to investigate the effect of OCP cessation on HCA size. Methods A retrospective cohort study was performed including HCA patients who stopped OCP intake within 6 months of imaging between 2005 and 2018. Biometrics and hormonal medication use were evaluated with self‐designed questionnaires. Response of the largest HCA was evaluated according to Response Evaluation Criteria in Solid Tumours (RECISTv1.1). Cox regression was performed for analysis of factors influencing HCA regression. Results Seventy‐eight HCA patients were included, diagnosed at a median (interquartile range) age of 32 (26‐41) years. Follow‐up was 1.6 (0.4‐2.9) years. HCA size at diagnosis ranged 10‐167 mm. After a median time of 1.3 (0.6‐2.6) years after OCP cessation, 37.2% of HCA showed ≥30% regression, 5.1% complete regression, 56.4% stability and 1.3% progression. No HCA‐induced complications were observed during follow‐up. Cox regression analysis demonstrated a significant association of HCA size with rate of regression; 50 ≤ HCA < 100 mm (HR 2.4, 95% CI 1.1‐5.3; P < 0.05), HCA ≥ 100 mm (HR 8.3, 95% CI 3.3‐21.6; P < 0.001). Conclusions Ninety‐eight per cent of HCA remained stable or regressed after OCP cessation. A longer wait‐and‐see period was associated with a larger proportion of regressing HCA, without HCA‐related complications during follow‐up.

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