Background and Methods To detect potentially curable cases ofhepatocellular carcinoma, outpatients with chronic hepatitisor compensated liver cirrhosis who were seen at the Center forAdult Diseases (Osaka, Japan) were examined periodically bymeans of ultrasonography and measurement of serum alpha-fetoprotein.Risk factors for hepatocellular carcinoma were identified witha Cox proportional-hazards model.
Results A total of 917 patients, 40 to 69 years old, were registeredfrom May 1987 to March 1991. By the end of September 1991, livercancer had developed in 54. The three-year cumulative risk ofliver cancer was 12.5 percent for 240 patients with liver cirrhosisat enrollment and 3.8 percent for 677 patients with chronichepatitis. Cox regression analysis showed that the risk of livercancer was increased almost sevenfold in patients with hepatitisB surface antigen (rate ratio, 6.92; 95 percent confidence interval,2.92 to 16.39) and fourfold in patients with hepatitis C antibody(rate ratio, 4.09; 95 percent confidence interval, 1.30 to 12.85).A high alpha-fetoprotein value at enrollment was also a riskmarker for liver cancer.
Conclusions Patients with hepatitis C virus infection have agreatly increased risk of liver cancer. Further studies arerequired to clarify the roles of other risk factors, includingdrinking and smoking habits.
Source Information
From the Department of Field Research (H.T., I.F.), Research Institute (T.H.), and Hospital (S.T., M.N., T.Y., T. Kitamura, K.N., A.I.), Center for Adult Diseases, and the Center for Cancer Detection and Prevention (H.Y., T. Kawashima), Osaka, Japan.
Address reprint requests to Dr. Tsukuma at the Department of Field Research, Center for Adult Diseases, Osaka, 3-3 Nakamichi 1-chome, Higashinari-ku, Osaka 537, Japan.
Treatment of Unresectable Hepatocellular Carcinoma
Stuart K., Vauthey J. N., Marsh R. d. W., Davis G. L., Rees C. R., Bismuth H., Samuel D., Engerran L., Trinchet J.-C., Chevret S., Mathieu D., The Groupe d'Etude et de Traitement du Carcinome Hepatocéllulaire
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N Engl J Med 1995;
333:877-878, Sep 28, 1995.
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