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©The Author(s) 2017.
World J Gastroenterol. Apr 21, 2017; 23(15): 2763-2770
Published online Apr 21, 2017. doi: 10.3748/wjg.v23.i15.2763
Published online Apr 21, 2017. doi: 10.3748/wjg.v23.i15.2763
Table 1 Etiology of liver disease n (%)
HBV | HCV | Non-viral | |
No patients | 467 (29) | 299 (45) | 268 (26) |
Etiology of non-viral liver disease | |||
Alcoholic liver disease | 144 (53.7) | ||
NAFLD | 85 (31.7) | ||
Haemochromatosis | 18 (6.7) | ||
Primary sclerosing cholangitis | 6 (2.3) | ||
Primary biliary cirrhosis | 8 (3) | ||
Alpha-1 antitrypsin deficiency | 3 (1.1) | ||
Congenital hepatic fibrosis | 1 (0.4) | ||
Autoimmune hepatitis | 3 (1.1) |
Table 2 Patient characteristics according to etiology of liver disease
HBV | HCV | Non-viral | P value | |
Male (%) | 84.3 | 79.2 | 80.6 | < 0.250 |
Ethnicity (%) | ||||
Caucasian | 16.4 | 73.4 | 87.3 | < 0.001 |
Asian | 75.8 | 18.2 | 9.0 | < 0.001 |
Middle Eastern | 3.7 | 7.1 | 2.2 | < 0.001 |
Polynesian | 2.3 | 0.6 | 0.0 | < 0.001 |
Aboriginal | 0.3 | 0.2 | 1.1 | < 0.001 |
African | 1.3 | 0.4 | 0.4 | < 0.001 |
Median age (95%CI) | 57 (55-59) | 55 (54-56) | 64 (63-65) | < 0.001 |
Screening program (%) | 71 | 84 | 71 | < 0.001 |
Median AFP (95%CI) | 60 (40-98) | 21 (16-28) | 9 (6-19) | < 0.001 |
Table 3 Severity of liver disease and cirrhosis at hepatocellular carcinoma diagnosis
HBV (%) | HCV (%) | Non-viral (%) | P value | |
Child-Pugh score | ||||
A | 58.6 | 53.9 | 41.9 | < 0.001 |
B | 13.7 | 29.0 | 28.3 | < 0.001 |
C | 4.9 | 14.4 | 17.1 | < 0.001 |
Non-cirrhotic | 22.8 | 2.6 | 12.8 | < 0.001 |
Median MELD score | 6.4 | 8.2 | 8.8 | < 0.001 |
Cirrhosis | 77.8 | 97.4 | 87.2 | < 0.001 |
Table 4 Tumor characteristics and vascular invasion
HBV (%) | HCV (%) | Non-viral (%) | P value | |
Size of dominant lesion | ||||
< 1 cm | 1.3 | 2.8 | 2.6 | < 0.001 |
1-3 cm | 34.4 | 46.5 | 32.1 | < 0.001 |
3-5 cm | 22.4 | 23.8 | 20.5 | < 0.001 |
> 5 cm | 32.0 | 18.0 | 34.0 | < 0.001 |
Unknown | 10.0 | 9.2 | 10.4 | < 0.001 |
Tumor extent > 50% | 12.4 | 4.2 | 12.5 | < 0.001 |
Vascular invasion | 10.4 | 6.7 | 12.3 | < 0.020 |
Table 5 Treatment modalities used for patients with hepatocellular carcinoma
Treatment | Hepatitis B (%) | Hepatitis C (%) | Non-viral (%) | P value |
TACE | 44.5 | 45.4 | 39.2 | 0.099 |
Ablation | 11.1 | 18.4 | 10.8 | 0.011 |
Resection | 24.4 | 8.8 | 13.1 | < 0.001 |
Transplant | 13.4 | 21.4 | 12.3 | 0.001 |
Sorafenib | 5 | 4.1 | 4.1 | 0.098 |
Supportive care | 21 | 20 | 29 | < 0.02 |
Table 6 Multivariate analysis for predictors of survival
Variable | Reference | HR | 95%CI for HR | P value |
Hepatitis B | Non-viral | 0.900 | 0.674-1.200 | 0.472 |
Hepatitis C | Non-viral | 1.086 | 0.841-1.401 | 0.527 |
Age at presentation | Years | 1.009 | 1.000-1.018 | 0.062 |
Non-cirrhotic | Child Pugh C | 0.267 | 0.165-0.433 | < 0.001 |
Child Pugh A | Child Pugh C | 0.403 | 0.287-0.566 | < 0.001 |
Child Pugh B | Child Pugh C | 0.705 | 0.501-0.992 | 0.045 |
Gender | Male | 0.978 | 0.748-1.280 | 0.874 |
MELD | MELD score | 1.016 | 0.999-1.033 | 0.072 |
Resection | Yes | 2.212 | 1.434-3.413 | < 0.001 |
Dominant lesion < 1 cm | Dominant lesion > 5 cm | 0.375 | 0.156-0.898 | 0.028 |
Dominant lesion 1-3 cm | Dominant lesion > 5 cm | 0.527 | 0.394-0.704 | < 0.001 |
Dominant lesion 3-5 cm | Dominant lesion > 5 cm | 0.740 | 0.550-0.995 | 0.046 |
Sorafenib | Yes | 1.118 | 0.688-1.817 | 0.652 |
TACE | Yes | 1.371 | 0.938-2.004 | 0.103 |
Transplant | Yes | 8.486 | 5.185-13.889 | < 0.001 |
Tumor extent < 50% | Tumor extent > 50% | 0.690 | 0.476-1.000 | 0.050 |
Vascular invasion | Yes | 0.555 | 0.393-0.784 | 0.001 |
- Citation: Mohsen W, Rodov M, Prakoso E, Charlton B, Bowen DG, Koorey DJ, Shackel NA, McCaughan GW, Strasser SI. Patients with non-viral liver disease have a greater tumor burden and less curative treatment options when diagnosed with hepatocellular carcinoma. World J Gastroenterol 2017; 23(15): 2763-2770
- URL: https://www.wjgnet.com/1007-9327/full/v23/i15/2763.htm
- DOI: https://dx.doi.org/10.3748/wjg.v23.i15.2763