Clinical characteristics and prognosis of non-B non-C hepatocellular carcinoma patients with modest alcohol consumption

Yohei Urata; Takahiro Yamasaki; Issei Saeki; Shuji Iwai; Masaaki Kitahara; Yoshiyuki Sawai; Kazunari Tanaka; Tomoko Aoki; Shouta Iwadou; Naoki Fujita; Yasuhiro Nakayama; Tatsuji Maeshiro; Taro Takami; Isao Sakaida

doi:10.1111/hepr.12572

Clinical characteristics and prognosis of non-B non-C hepatocellular carcinoma patients with modest alcohol consumption

Hepatol Res. 2016 Mar;46(5):434-42. doi: 10.1111/hepr.12572. Epub 2015 Sep 9.

Authors

Yohei Urata^{1

2}, Takahiro Yamasaki^{1

3}, Issei Saeki¹, Shuji Iwai⁴, Masaaki Kitahara⁵, Yoshiyuki Sawai⁶, Kazunari Tanaka⁷, Tomoko Aoki^{8

9}, Shouta Iwadou¹⁰, Naoki Fujita¹¹, Yasuhiro Nakayama¹², Tatsuji Maeshiro¹³, Taro Takami¹, Isao Sakaida¹

Affiliations

¹ Department of Gastroenterology and Hepatology, Yamaguchi University Graduate School of Medicine, Yamaguchi, Japan.
² Department of Gastroenterology, Yamaguchi Rosai Hospital, Yamaguchi, Japan.
³ Department of Oncology and Laboratory, Yamaguchi University Graduate School of Medicine, Yamaguchi, Japan.
⁴ Department of Hepatology, Osaka City University Graduate School of Medicine, Osaka, Japan.
⁵ Department of Gastroenterology, Graduate School of Medicine, Kanazawa University, Kanazawa, Japan.
⁶ Department of Gastroenterology, Ikeda Municipal Hospital, Osaka, Japan.
⁷ Center for Gastroenterology, Teine Keijinkai Hospital, Sapporo, Japan.
⁸ Division of Hepatobiliary and Pancreatic Disease, Department of Internal Medicine, Hyogo College of Medicine, Hyogo, Japan.
⁹ Ultrasound Imaging Center, Hyogo College of Medicine, Hyogo, Japan.
¹⁰ Department of Internal Medicine, Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan.
¹¹ Department of Gastroenterology and Hepatology, Mie University School of Medicine, Mie, Japan.
¹² First Department of Internal Medicine, Faculty of Medicine, University of Yamanashi, Yamanashi, Japan.
¹³ First Department of Internal Medicine, Faculty of Medicine, University of the Ryukyus, Okinawa, Japan.

PMID: 26288059
DOI: 10.1111/hepr.12572

Abstract

Aim: Alcoholic hepatocellular carcinoma (ALD-HCC) accounts for the majority of non-B non-C HCC (NBNC-HCC) cases. Although alcohol is a potent carcinogen, there have been few reports on the influence of modest alcohol consumption in NBNC-HCC. This study aimed to investigate the clinical characteristics and prognosis of NBNC-HCC patients with modest alcohol consumption.

Methods: From 2007 to 2010, 2283 HCC patients were evaluated at 10 hospitals. We collected detailed etiology data of 588 NBNC-HCC patients and compared the clinical characteristics and prognosis between ALD-HCC and modest alcohol-HCC patients.

Results: There were 69 HCC patients with modest alcohol consumption, accounting for 3% of all HCC patients evaluated. This patient group had significantly more women and higher prevalence of Child-Pugh class A, hypertension and advanced disease stage, and were diagnosed with HCC at an older age than the ALD-HCC group (266 patients). Additionally, among the modest alcohol-HCC patients, diabetes was significantly more common in the anti-hepatitis B core (HBc) negative subgroup than in the anti-HBc positive subgroup. However, no significant difference in survival was observed between the two patient groups regardless of significant differences in tumor staging. Alcohol consumption and metabolic factors were not significant independent predictors of survival.

Conclusion: The clinical characteristics of modest alcohol-HCC included advanced staging, favorable liver reserve capacity and older age at diagnosis. HCC development in patients with modest alcohol consumption may relate to metabolic factors. Although approximately 30% of the evaluated HCC cases were in advanced stages, the prognosis of NBNC-HCC patients with modest alcohol consumption was relatively favorable.

Keywords: alcoholic liver disease; hepatocellular carcinoma; modest alcohol consumption; non-B non-C; prognosis.