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High HCC incident rate observed in patients with alcohol cirrhosis

VIENNA — A number of patients with alcohol-related cirrhosis developed hepatocellular carcinoma and other complications over time, regardless of alcohol and tobacco consumption, according to data presented at the 2015 International Liver Congress.

“In France, as probably in many other European countries, alcohol remains the leading cause of the underlying chronic liver disease,” Nathalie Ganne, MD, PhD, of the Assistance Publique hôpitaux de Paris, Jean Verdier, Bondy, told Healio.com/Hepatology.

Ganne and colleagues analyzed data of 548 patients (median age, 59 years) with histologically proven alcohol-related cirrhosis or Child-Pugh A cirrhosis consecutively enrolled in 20 centers across France from October 2010 to September 2014. Of the patients, 524 did not have any evidence of hepatic focal nodule and 24 had hepatic focal nodule. All were screened for HCC and none of the patients had any previous HBV or HCV infection or HCC.

“Primary liver cirrhosis has high incidence in Europe,” Ganne said during her presentation. “The aim of the study was to describe the natural history of compensated Child-Pugh A cirrhosis and identify and validate risk factors associated with the occurrence of complications, mainly HCC.”

Sixty-five percent of patients were currently completely abstinent from alcohol (median duration of withdrawal: 28.8 months) and 15% reported consuming less than seven glasses per week. Thirty-five percent of the patients had a previous history of tobacco-use, with 39% of patients being active smokers. In addition, 78% of patients reported consuming coffee on a regular basis (median: 2 cups per day) and 39% reported consuming more than three cups per day.

Over a median follow-up of 17 months, liver nodules occurred in 73 patients and had a 1-year cumulative incidence of 10.7% and HCC was diagnosed in 18 with a 1-year cumulative incidence of 1.6%, without any statistically difference according to alcohol consumption or the presence of metabolic syndrome. The 2-year cumulative incidence was 4.6%, suggesting that there is an annual incidence of HCC around 3% in patients with alcoholic compensated Child-Pugh A cirrhosis, Ganne said. The 2-year overall survival was 92.1% and the event-free survival rate at 2 years was 80.2%, according to the presentation.

“This is the first interim analysis of 599 patients,” Ganne said. “A high incidence of hepatic focal lesions was observed and suggests that 10% of patients per year will need a recall diagnosis procedure.” – by Melinda Stevens

For More Information:

Ganne N. Abstract G09. Presented at: International Liver Congress; April 22-26, 2015; Vienna.

Disclosure: The researchers report no relevant financial disclosures. 

Editor's note: This article has been updated with additional information provided by the presenter.