Copyright
©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
Impact of alcohol consumption on treatment outcome of hepatocellular carcinoma patients with viral hepatitis who underwent transarterial chemoembolization
Attapon Rattanasupar, Arunchai Chang, Tanaporn Prateepchaiboon, Nuttanit Pungpipattrakul, Keerati Akarapatima, Apiradee Songjamrat, Songklod Pakdeejit, Varayu Prachayakul, Teerha Piratvisuth
Attapon Rattanasupar, Arunchai Chang, Keerati Akarapatima, Division of Gastroenterology, Department of Internal Medicine, Hatyai Hospital, Hatyai 90110, Songkhla, Thailand
Tanaporn Prateepchaiboon, Nuttanit Pungpipattrakul, Department of Internal Medicine, Hatyai Hospital, Hatyai 90110, Songkhla, Thailand
Apiradee Songjamrat, Songklod Pakdeejit, Division of Intervention Radiology, Department of Radiology, Hatyai Hospital, Hatyai 90110, Songkhla, Thailand
Varayu Prachayakul, Siriraj Gastrointestinal Endoscopy Center, Division of Gastroenterology, Department of Internal Medicine, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkoknoi 10700, Bangkok, Thailand
Teerha Piratvisuth, NKC Institute of Gastroenterology and Hepatology, Songklanagarind Hospital, Faculty of Medicine, Prince of Songkla University, Hatyai 90110, Songkhla, Thailand
Author contributions: Rattanasupar A designed and conceptualized the study, acquired the data and drafted the manuscript; Chang A designed and conceptualized the study, acquired, analyzed, and interpreted the data, and drafted the manuscript; Prateepchaiboon T designed and conceptualized the study, acquired, analyzed, and interpreted the data; Pungpipattrakul N, Akarapatima K, Songjamrat A, and Pakdeejit S acquired, analyzed, and interpreted the data; Prachayakul V and Piratvisuth T critically revised the manuscript for important intellectual content.
Institutional review board statement: The study was reviewed and approved for publication by the Institutional Review Board of Hatyai Hospital (protocol number HYH EC 105-64-01.
Informed consent statement: The need for informed consent was waived because the de-identification of patient information before analysis.
Conflict-of-interest statement: All the authors declare that they have no conflict of interest.
Data sharing statement: No additional data are available
STROBE statement: All the authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
https://creativecommons.org/Licenses/by-nc/4.0/ Corresponding author: Arunchai Chang, MD, Assistant Professor, Doctor, Division of Gastroenterology, Department of Internal Medicine, Hatyai Hospital, 182 Ruthakal road, Hatyai, Hatyai 90110, Songkhla, Thailand. busmdcu58@gmail.com
Received: February 4, 2022
Peer-review started: February 4, 2022
First decision: April 17, 2022
Revised: April 24, 2022
Accepted: June 13, 2022
Article in press: June 13, 2022
Published online: June 27, 2022
ARTICLE HIGHLIGHTS
Research background
Alcohol consumption increases the risk of hepatocellular carcinoma (HCC) in patients with pre-existing liver disease, including viral hepatitis. However, the impact of alcohol consumption on the outcomes of HCC remained questionable.
Research motivation
We hypothesized that alcohol had an additional effect with chronic viral hepatitis infection on treatment outcomes after transarterial chemoembolization (TACE) in patients with intermediate-stage HCC (Barcelona Clinical Liver Cancer [BCLC] -B).
Research objectives
We aims to evaluate the additional effect of alcohol on treatment outcomes of TACE among HCC patients with viral hepatitis.
Research methods
We conducted a retrospective review the records of 69 HCC patients with viral hepatitis classified as BCLC B who underwent TACE as the first-line treatment between 2014 and 2019 at Hatyai Hospital. Patients with chronic viral hepatitis only were categorized under group A and those with chronic viral hepatitis and concurrent alcohol consumption were categorized under group B. Both groups were compared, and the Cox proportional hazards model was used to identify variables influencing survival.
Research results
We find that patients who had chronic viral hepatitis alone had a statistically significantly higher proportion of complete response (24.5% vs 0%, P = 0.030) and a higher median survival rate (26.2 mo vs 8.4 mo; log-rank P = 0.012) than those with chronic viral hepatitis concurrent with alcohol consumption. Alcohol consumption was an independent factor associated with decreased survival in the proportional hazards model included (hazards ratio [HR], 2.377; 95% confidence interval [CI], 1.109-5.095; P = 0.026).
Research conclusions
In HCC BCLC B patients with chronic viral hepatitis, alcohol consumption is an independent risk factor for increased mortality and decreases the rate of complete response and survival after TACE.
Research perspectives
This research underscore that alcohol consumption leads to worse outcomes after TACE in intermediate stage HCC patients with chronic viral hepatitis.
