Are patients with cirrhotic stage primary sclerosing cholangitis at risk for the development of hepatocellular cancer?

Denise Harnois, Gregory James Gores, Jurgen Ludwig, Jeffery L. Steers, Nicholas F La Russo, Russell H. Wiesner

Research output: Contribution to journalArticle

76 Citations (Scopus)

Abstract

Background/Aims: The risk of cholangiocarcinoma in primary sclerosing cholangitis is widely recognized to be 8-30%, whereas the risk of acquiring hepatocellular carcinoma in primary sclerosing cholangitis is unknown. As in other chronic liver diseases, the presence of hepatocellular carcinoma in a patient with primary sclerosing cholangitis undergoing evaluation for orthotopic liver transplantation would clearly impact on the candidacy, diagnostic evaluation, and alternative treatment options. Thus, the aim of our study was to determine the prevalence of hepatocellular carcinoma in patients undergoing liver transplantation for primary sclerosing cholangitis. Methods: The records of the 520 patients undergoing orthotopic liver transplantation at our institution between 1985 and May 1995 were reviewed. Of the 134 patients with primary sclerosing cholangitis, three (2%) had hepatocellular carcinoma. In the 386 patients without primary sclerosing cholangitis under-going orthotopic liver transplantation, 22 (6%) had hepatocellular carcinoma. Results: Neither the duration of primary sclerosing cholangitis (range 7-23 years) nor the presence of ulcerative colitis (two of three patients) distinguished those patients with primary sclerosing cholangitis plus hepatocellular carcinoma from those with primary sclerosing cholangitis alone. None of the three patients with primary sclerosing cholangitis plus hepatocellular carcinoma had evidence for hepatitis B or C, alpha-1-antitrypsin deficiency, or hemochromatosis. None of the tumors was of the fibrolamellar variety of hepatocellular carcinoma. Conclusions: The prevalence of hepatocellular carcinoma in patients with primary sclerosing cholangitis undergoing orthotopic liver transplantation is 2%. These data suggest that patients with advanced cirrhotic-stage primary sclerosing cholangitis are at increased risk for developing hepatocellular carcinoma and should be screened for hepatocellular carcinoma as well as for cholangiocarcinoma prior to orthotopic liver transplantation.

Original languageEnglish (US)
Pages (from-to)512-516
Number of pages5
JournalJournal of Hepatology
Volume27
Issue number3
DOIs
StatePublished - Sep 1997

Fingerprint

Sclerosing Cholangitis
Liver Neoplasms
Hepatocellular Carcinoma
Liver Transplantation
Cholangiocarcinoma
alpha 1-Antitrypsin Deficiency
Hemochromatosis
Hepatitis C
Hepatitis B
Ulcerative Colitis
Liver Diseases
Chronic Disease

Keywords

  • Fibrolamellar hepatocellular carcinoma
  • Inflammatory bowel disease
  • Screening

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Are patients with cirrhotic stage primary sclerosing cholangitis at risk for the development of hepatocellular cancer? / Harnois, Denise; Gores, Gregory James; Ludwig, Jurgen; Steers, Jeffery L.; La Russo, Nicholas F; Wiesner, Russell H.

In: Journal of Hepatology, Vol. 27, No. 3, 09.1997, p. 512-516.

Research output: Contribution to journalArticle

@article{864ef19081014d6d93042823c3cd38d9,
title = "Are patients with cirrhotic stage primary sclerosing cholangitis at risk for the development of hepatocellular cancer?",
abstract = "Background/Aims: The risk of cholangiocarcinoma in primary sclerosing cholangitis is widely recognized to be 8-30{\%}, whereas the risk of acquiring hepatocellular carcinoma in primary sclerosing cholangitis is unknown. As in other chronic liver diseases, the presence of hepatocellular carcinoma in a patient with primary sclerosing cholangitis undergoing evaluation for orthotopic liver transplantation would clearly impact on the candidacy, diagnostic evaluation, and alternative treatment options. Thus, the aim of our study was to determine the prevalence of hepatocellular carcinoma in patients undergoing liver transplantation for primary sclerosing cholangitis. Methods: The records of the 520 patients undergoing orthotopic liver transplantation at our institution between 1985 and May 1995 were reviewed. Of the 134 patients with primary sclerosing cholangitis, three (2{\%}) had hepatocellular carcinoma. In the 386 patients without primary sclerosing cholangitis under-going orthotopic liver transplantation, 22 (6{\%}) had hepatocellular carcinoma. Results: Neither the duration of primary sclerosing cholangitis (range 7-23 years) nor the presence of ulcerative colitis (two of three patients) distinguished those patients with primary sclerosing cholangitis plus hepatocellular carcinoma from those with primary sclerosing cholangitis alone. None of the three patients with primary sclerosing cholangitis plus hepatocellular carcinoma had evidence for hepatitis B or C, alpha-1-antitrypsin deficiency, or hemochromatosis. None of the tumors was of the fibrolamellar variety of hepatocellular carcinoma. Conclusions: The prevalence of hepatocellular carcinoma in patients with primary sclerosing cholangitis undergoing orthotopic liver transplantation is 2{\%}. These data suggest that patients with advanced cirrhotic-stage primary sclerosing cholangitis are at increased risk for developing hepatocellular carcinoma and should be screened for hepatocellular carcinoma as well as for cholangiocarcinoma prior to orthotopic liver transplantation.",
keywords = "Fibrolamellar hepatocellular carcinoma, Inflammatory bowel disease, Screening",
author = "Denise Harnois and Gores, {Gregory James} and Jurgen Ludwig and Steers, {Jeffery L.} and {La Russo}, {Nicholas F} and Wiesner, {Russell H.}",
year = "1997",
month = "9",
doi = "10.1016/S0168-8278(97)80356-X",
language = "English (US)",
volume = "27",
pages = "512--516",
journal = "Journal of Hepatology",
issn = "0168-8278",
publisher = "Elsevier",
number = "3",

}

TY - JOUR

T1 - Are patients with cirrhotic stage primary sclerosing cholangitis at risk for the development of hepatocellular cancer?

AU - Harnois, Denise

AU - Gores, Gregory James

AU - Ludwig, Jurgen

AU - Steers, Jeffery L.

AU - La Russo, Nicholas F

AU - Wiesner, Russell H.

PY - 1997/9

Y1 - 1997/9

N2 - Background/Aims: The risk of cholangiocarcinoma in primary sclerosing cholangitis is widely recognized to be 8-30%, whereas the risk of acquiring hepatocellular carcinoma in primary sclerosing cholangitis is unknown. As in other chronic liver diseases, the presence of hepatocellular carcinoma in a patient with primary sclerosing cholangitis undergoing evaluation for orthotopic liver transplantation would clearly impact on the candidacy, diagnostic evaluation, and alternative treatment options. Thus, the aim of our study was to determine the prevalence of hepatocellular carcinoma in patients undergoing liver transplantation for primary sclerosing cholangitis. Methods: The records of the 520 patients undergoing orthotopic liver transplantation at our institution between 1985 and May 1995 were reviewed. Of the 134 patients with primary sclerosing cholangitis, three (2%) had hepatocellular carcinoma. In the 386 patients without primary sclerosing cholangitis under-going orthotopic liver transplantation, 22 (6%) had hepatocellular carcinoma. Results: Neither the duration of primary sclerosing cholangitis (range 7-23 years) nor the presence of ulcerative colitis (two of three patients) distinguished those patients with primary sclerosing cholangitis plus hepatocellular carcinoma from those with primary sclerosing cholangitis alone. None of the three patients with primary sclerosing cholangitis plus hepatocellular carcinoma had evidence for hepatitis B or C, alpha-1-antitrypsin deficiency, or hemochromatosis. None of the tumors was of the fibrolamellar variety of hepatocellular carcinoma. Conclusions: The prevalence of hepatocellular carcinoma in patients with primary sclerosing cholangitis undergoing orthotopic liver transplantation is 2%. These data suggest that patients with advanced cirrhotic-stage primary sclerosing cholangitis are at increased risk for developing hepatocellular carcinoma and should be screened for hepatocellular carcinoma as well as for cholangiocarcinoma prior to orthotopic liver transplantation.

AB - Background/Aims: The risk of cholangiocarcinoma in primary sclerosing cholangitis is widely recognized to be 8-30%, whereas the risk of acquiring hepatocellular carcinoma in primary sclerosing cholangitis is unknown. As in other chronic liver diseases, the presence of hepatocellular carcinoma in a patient with primary sclerosing cholangitis undergoing evaluation for orthotopic liver transplantation would clearly impact on the candidacy, diagnostic evaluation, and alternative treatment options. Thus, the aim of our study was to determine the prevalence of hepatocellular carcinoma in patients undergoing liver transplantation for primary sclerosing cholangitis. Methods: The records of the 520 patients undergoing orthotopic liver transplantation at our institution between 1985 and May 1995 were reviewed. Of the 134 patients with primary sclerosing cholangitis, three (2%) had hepatocellular carcinoma. In the 386 patients without primary sclerosing cholangitis under-going orthotopic liver transplantation, 22 (6%) had hepatocellular carcinoma. Results: Neither the duration of primary sclerosing cholangitis (range 7-23 years) nor the presence of ulcerative colitis (two of three patients) distinguished those patients with primary sclerosing cholangitis plus hepatocellular carcinoma from those with primary sclerosing cholangitis alone. None of the three patients with primary sclerosing cholangitis plus hepatocellular carcinoma had evidence for hepatitis B or C, alpha-1-antitrypsin deficiency, or hemochromatosis. None of the tumors was of the fibrolamellar variety of hepatocellular carcinoma. Conclusions: The prevalence of hepatocellular carcinoma in patients with primary sclerosing cholangitis undergoing orthotopic liver transplantation is 2%. These data suggest that patients with advanced cirrhotic-stage primary sclerosing cholangitis are at increased risk for developing hepatocellular carcinoma and should be screened for hepatocellular carcinoma as well as for cholangiocarcinoma prior to orthotopic liver transplantation.

KW - Fibrolamellar hepatocellular carcinoma

KW - Inflammatory bowel disease

KW - Screening

UR - http://www.scopus.com/inward/record.url?scp=0030841585&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0030841585&partnerID=8YFLogxK

U2 - 10.1016/S0168-8278(97)80356-X

DO - 10.1016/S0168-8278(97)80356-X

M3 - Article

C2 - 9314129

AN - SCOPUS:0030841585

VL - 27

SP - 512

EP - 516

JO - Journal of Hepatology

JF - Journal of Hepatology

SN - 0168-8278

IS - 3

ER -