More advanced disease and worse survival in cryptogenic compared to viral hepatocellular carcinoma

Tomi W. Jun, Ming Lun Yeh, Ju Dong Yang, Vincent L. Chen, Pauline Nguyen, Nasra H. Giama, Chung Feng Huang, Ann W. Hsing, Chia Yen Dai, Jee Fu Huang, Wan Long Chuang, Lewis Rowland Roberts, Ming Lung Yu, Mindie H. Nguyen

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Background & Aims: Although hepatitis B virus (HBV) and hepatitis C virus (HCV) infections remain major risk factors for hepatocellular carcinoma (HCC), non-viral causes of HCC, particularly non-alcoholic fatty liver disease (NAFLD), are becoming increasingly prevalent. The aim of this study was to compare the clinical characteristics and survival of cryptogenic and viral HCC. Methods: We conducted a retrospective cohort study involving 3878 consecutive HCC patients seen at two tertiary centres in the United States and one in Taiwan from 2004 to 2014. We compared the clinical characteristics, treatment and survival of patients by underlying aetiology: cryptogenic (n = 696), HBV (n = 1304) or HCV (n = 1878). Results: Cirrhosis was present in 66.8% of the cryptogenic HCC patients, compared with 74.7% of HBV-related HCC (HBV-HCC) (P = .001) and 85.9% of HCV-HCC (P < .001). Compared to viral HCC, cryptogenic HCC patients presented with larger tumours and at later stages of disease. Five-year overall survival was 16.3% among cryptogenic HCC patients compared with 31.9% among HBV-HCC patients and 27.7% among HCV-HCC patients (P < .001 for both by the log-rank test). HCC aetiology was not an independent predictor of survival, though ethnicity, cirrhosis status, meeting Milan criteria and treatment allocation were. Conclusions: Compared with viral HCC patients, those with cryptogenic HCC had lower prevalence of cirrhosis, were diagnosed with larger tumours at more advanced stages of disease, and had poorer overall survival. Additional efforts are needed to identify patients at risk of cryptogenic HCC and to identify cryptogenic HCC at earlier stages of disease.

Original languageEnglish (US)
JournalLiver International
DOIs
StateAccepted/In press - 2017

Fingerprint

Hepatocellular Carcinoma
Survival
Hepatitis B virus
Hepacivirus
Fibrosis
Virus Diseases
Taiwan
Neoplasms
Cohort Studies
Retrospective Studies

Keywords

  • Cryptogenic HCC
  • Hepatitis B
  • Hepatitis C
  • Hepatocellular carcinoma

ASJC Scopus subject areas

  • Hepatology

Cite this

Jun, T. W., Yeh, M. L., Yang, J. D., Chen, V. L., Nguyen, P., Giama, N. H., ... Nguyen, M. H. (Accepted/In press). More advanced disease and worse survival in cryptogenic compared to viral hepatocellular carcinoma. Liver International. https://doi.org/10.1111/liv.13613

More advanced disease and worse survival in cryptogenic compared to viral hepatocellular carcinoma. / Jun, Tomi W.; Yeh, Ming Lun; Yang, Ju Dong; Chen, Vincent L.; Nguyen, Pauline; Giama, Nasra H.; Huang, Chung Feng; Hsing, Ann W.; Dai, Chia Yen; Huang, Jee Fu; Chuang, Wan Long; Roberts, Lewis Rowland; Yu, Ming Lung; Nguyen, Mindie H.

In: Liver International, 2017.

Research output: Contribution to journalArticle

Jun, TW, Yeh, ML, Yang, JD, Chen, VL, Nguyen, P, Giama, NH, Huang, CF, Hsing, AW, Dai, CY, Huang, JF, Chuang, WL, Roberts, LR, Yu, ML & Nguyen, MH 2017, 'More advanced disease and worse survival in cryptogenic compared to viral hepatocellular carcinoma', Liver International. https://doi.org/10.1111/liv.13613
Jun, Tomi W. ; Yeh, Ming Lun ; Yang, Ju Dong ; Chen, Vincent L. ; Nguyen, Pauline ; Giama, Nasra H. ; Huang, Chung Feng ; Hsing, Ann W. ; Dai, Chia Yen ; Huang, Jee Fu ; Chuang, Wan Long ; Roberts, Lewis Rowland ; Yu, Ming Lung ; Nguyen, Mindie H. / More advanced disease and worse survival in cryptogenic compared to viral hepatocellular carcinoma. In: Liver International. 2017.
@article{25f29a6952d248c5b2abcbd491259e7f,
title = "More advanced disease and worse survival in cryptogenic compared to viral hepatocellular carcinoma",
abstract = "Background & Aims: Although hepatitis B virus (HBV) and hepatitis C virus (HCV) infections remain major risk factors for hepatocellular carcinoma (HCC), non-viral causes of HCC, particularly non-alcoholic fatty liver disease (NAFLD), are becoming increasingly prevalent. The aim of this study was to compare the clinical characteristics and survival of cryptogenic and viral HCC. Methods: We conducted a retrospective cohort study involving 3878 consecutive HCC patients seen at two tertiary centres in the United States and one in Taiwan from 2004 to 2014. We compared the clinical characteristics, treatment and survival of patients by underlying aetiology: cryptogenic (n = 696), HBV (n = 1304) or HCV (n = 1878). Results: Cirrhosis was present in 66.8{\%} of the cryptogenic HCC patients, compared with 74.7{\%} of HBV-related HCC (HBV-HCC) (P = .001) and 85.9{\%} of HCV-HCC (P < .001). Compared to viral HCC, cryptogenic HCC patients presented with larger tumours and at later stages of disease. Five-year overall survival was 16.3{\%} among cryptogenic HCC patients compared with 31.9{\%} among HBV-HCC patients and 27.7{\%} among HCV-HCC patients (P < .001 for both by the log-rank test). HCC aetiology was not an independent predictor of survival, though ethnicity, cirrhosis status, meeting Milan criteria and treatment allocation were. Conclusions: Compared with viral HCC patients, those with cryptogenic HCC had lower prevalence of cirrhosis, were diagnosed with larger tumours at more advanced stages of disease, and had poorer overall survival. Additional efforts are needed to identify patients at risk of cryptogenic HCC and to identify cryptogenic HCC at earlier stages of disease.",
keywords = "Cryptogenic HCC, Hepatitis B, Hepatitis C, Hepatocellular carcinoma",
author = "Jun, {Tomi W.} and Yeh, {Ming Lun} and Yang, {Ju Dong} and Chen, {Vincent L.} and Pauline Nguyen and Giama, {Nasra H.} and Huang, {Chung Feng} and Hsing, {Ann W.} and Dai, {Chia Yen} and Huang, {Jee Fu} and Chuang, {Wan Long} and Roberts, {Lewis Rowland} and Yu, {Ming Lung} and Nguyen, {Mindie H.}",
year = "2017",
doi = "10.1111/liv.13613",
language = "English (US)",
journal = "Liver International",
issn = "1478-3223",
publisher = "Wiley-Blackwell",

}

TY - JOUR

T1 - More advanced disease and worse survival in cryptogenic compared to viral hepatocellular carcinoma

AU - Jun, Tomi W.

AU - Yeh, Ming Lun

AU - Yang, Ju Dong

AU - Chen, Vincent L.

AU - Nguyen, Pauline

AU - Giama, Nasra H.

AU - Huang, Chung Feng

AU - Hsing, Ann W.

AU - Dai, Chia Yen

AU - Huang, Jee Fu

AU - Chuang, Wan Long

AU - Roberts, Lewis Rowland

AU - Yu, Ming Lung

AU - Nguyen, Mindie H.

PY - 2017

Y1 - 2017

N2 - Background & Aims: Although hepatitis B virus (HBV) and hepatitis C virus (HCV) infections remain major risk factors for hepatocellular carcinoma (HCC), non-viral causes of HCC, particularly non-alcoholic fatty liver disease (NAFLD), are becoming increasingly prevalent. The aim of this study was to compare the clinical characteristics and survival of cryptogenic and viral HCC. Methods: We conducted a retrospective cohort study involving 3878 consecutive HCC patients seen at two tertiary centres in the United States and one in Taiwan from 2004 to 2014. We compared the clinical characteristics, treatment and survival of patients by underlying aetiology: cryptogenic (n = 696), HBV (n = 1304) or HCV (n = 1878). Results: Cirrhosis was present in 66.8% of the cryptogenic HCC patients, compared with 74.7% of HBV-related HCC (HBV-HCC) (P = .001) and 85.9% of HCV-HCC (P < .001). Compared to viral HCC, cryptogenic HCC patients presented with larger tumours and at later stages of disease. Five-year overall survival was 16.3% among cryptogenic HCC patients compared with 31.9% among HBV-HCC patients and 27.7% among HCV-HCC patients (P < .001 for both by the log-rank test). HCC aetiology was not an independent predictor of survival, though ethnicity, cirrhosis status, meeting Milan criteria and treatment allocation were. Conclusions: Compared with viral HCC patients, those with cryptogenic HCC had lower prevalence of cirrhosis, were diagnosed with larger tumours at more advanced stages of disease, and had poorer overall survival. Additional efforts are needed to identify patients at risk of cryptogenic HCC and to identify cryptogenic HCC at earlier stages of disease.

AB - Background & Aims: Although hepatitis B virus (HBV) and hepatitis C virus (HCV) infections remain major risk factors for hepatocellular carcinoma (HCC), non-viral causes of HCC, particularly non-alcoholic fatty liver disease (NAFLD), are becoming increasingly prevalent. The aim of this study was to compare the clinical characteristics and survival of cryptogenic and viral HCC. Methods: We conducted a retrospective cohort study involving 3878 consecutive HCC patients seen at two tertiary centres in the United States and one in Taiwan from 2004 to 2014. We compared the clinical characteristics, treatment and survival of patients by underlying aetiology: cryptogenic (n = 696), HBV (n = 1304) or HCV (n = 1878). Results: Cirrhosis was present in 66.8% of the cryptogenic HCC patients, compared with 74.7% of HBV-related HCC (HBV-HCC) (P = .001) and 85.9% of HCV-HCC (P < .001). Compared to viral HCC, cryptogenic HCC patients presented with larger tumours and at later stages of disease. Five-year overall survival was 16.3% among cryptogenic HCC patients compared with 31.9% among HBV-HCC patients and 27.7% among HCV-HCC patients (P < .001 for both by the log-rank test). HCC aetiology was not an independent predictor of survival, though ethnicity, cirrhosis status, meeting Milan criteria and treatment allocation were. Conclusions: Compared with viral HCC patients, those with cryptogenic HCC had lower prevalence of cirrhosis, were diagnosed with larger tumours at more advanced stages of disease, and had poorer overall survival. Additional efforts are needed to identify patients at risk of cryptogenic HCC and to identify cryptogenic HCC at earlier stages of disease.

KW - Cryptogenic HCC

KW - Hepatitis B

KW - Hepatitis C

KW - Hepatocellular carcinoma

UR - http://www.scopus.com/inward/record.url?scp=85032910189&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85032910189&partnerID=8YFLogxK

U2 - 10.1111/liv.13613

DO - 10.1111/liv.13613

M3 - Article

C2 - 29045023

AN - SCOPUS:85032910189

JO - Liver International

JF - Liver International

SN - 1478-3223

ER -