Etiology of hepatocellular carcinoma in Latin America: a prospective, multicenter, international study
Journal Title: Annals of Hepatology - Year 2010, Vol 9, Issue 1
Abstract
Background/aims. No prospective study has been published investigating etiology of HCC in Latin America. The primary aim of this prospective study was to analyze the etiology of liver disease in patients with HCC from our area. Secondary aims were to evaluate staging using Okuda and BCLC classifications; and percentage of patients receiving treatment. Methods. The Governing Board of the Latin American Association for the Study of the Liver designed the protocol. During a 18 month period, all members were invited to load their incident HCC cases on line. Results. 240 cases from 9 countries were uploaded, 174 were male (72.5%), median age was 64 years, interquartile range 57-72. In 85.4% of cases, patients had underlying cirrhosis. Main etiological factors were: HCV in 74 patients (30.8%), alcohol in 49 (20.4%), cryptogenic cirrhosis in 35 (14.6%), HBV in 26 (10.8%), HCV plus alcohol in 14 (5.8%). Considering the combinations, hepatitis C was shown in 91 patients (38%); chronic alcoholism in 68 patients (28%); and hepatitis B in 33 patients (14%). There were no significant ifferences between the groups in the age at diagnosis. Percentage of male gender was higher in groups of alcohol (94%), HCV plus alcohol (93%) and HBV (85%) than in cryptogenic cirrhosis (60%) and HCV (59%) (p<0.001). Conclusions. Our prospective study showed that hepatitis C is the more frequent etiology of HCC in Latin America, followed by alcoholic cirrhosis. Demographical results showed a male predominance (male:female ratio 2.6) with an important proportion of patients being diagnosed at their sixties.
Authors and Affiliations
Eduardo Fassio, Solangel Díaz, Catalina Santa, María Reig, Yamila Martínez Artola, Angelo Alves de Mattos, Carlos Míguez, Joao Galizzi, Rodrigo Zapata, Ezequiel Ridruejo, Francisco de Souza, Nelia Hernández, Leonardo Pinchuk, the Multicenter Group for the Study of Hepatocarcinoma in Latin America, on behalf of the Asociación Latinoamericana para el Estudio del Hígado (ALEH)
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