Hepatic and extrahepatic cancer in cirrhosis

A longitudinal cohort study

Kenneth Berman, Sweta Tandra, Raj Vuppalanch, Marwan Ghabril, Kumar Sandrasegaran, James Nguyen, Helena Caffrey, Suthat Liangpunsakul, Lawrence Lumeng, Paul Kwo, Naga Chalasani

Research output: Contribution to journalArticle

20 Citations (Scopus)

Abstract

Objectives: We conducted a retrospective cohort study in cirrhotic patients to understand (i) the risk of developing hepatocellular carcinoma (HCC) after an initial negative screening computed tomography (CT) scan and its relationship with underlying etiology and (ii) the risk of extrahepatic cancers (EHCs). Methods: Our cohort consisted of 952 cirrhotics who had at least one contrast-enhanced CT scan over a 5-year period from 1997 to 2002. We assessed their risk of HCC and EHC until the study closure (31 December 2007). Using data from the Indiana State Cancer Registry (ISCR), standardized incidence ratios (SIRs) were calculated for HCC and EHC. Results: The cohort's follow-up was 4.73.0 years. The frequency of HCC at baseline and during follow-up was 6.9 and 7.2%, respectively. The 1-, 3-, and 5-year HCC incidence after an initial negative CT scan was 1.2, 4.4, and 7.8%, respectively. The 1-, 3-, and 5-year EHC incidence was 2.2, 4.5, and 6.8%, respectively. The most common EHCs were breast, lung, and lymphoma. Incidence of both HCC (P0.016) and EHC (P0.004) varied significantly by the etiology of underlying cirrhosis. The SIRs for HCC and EHC were 186 (95% confidence interval (CI) 140-238) and 1.83 (95% CI 1.36-2.36), respectively. Compared with adjusted ISCR data, cirrhosis due to alcohol (SIR 2.73, 95% CI 1.14-4.33) but not other etiologies had significantly higher incidence of EHC. Conclusions: This study furthers our understanding of HCC and EHC risk in cirrhosis. If confirmed by other studies, these data will assist in developing optimal strategies for monitoring of cancer in individuals with cirrhosis.

Original languageEnglish
Pages (from-to)899-906
Number of pages8
JournalAmerican Journal of Gastroenterology
Volume106
Issue number5
DOIs
StatePublished - May 2011

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Liver Neoplasms
Longitudinal Studies
Fibrosis
Cohort Studies
Hepatocellular Carcinoma
Neoplasms
Incidence
Tomography
Confidence Intervals
Registries
Lymphoma
Retrospective Studies
Alcohols
Breast Neoplasms
Lung

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Hepatic and extrahepatic cancer in cirrhosis : A longitudinal cohort study. / Berman, Kenneth; Tandra, Sweta; Vuppalanch, Raj; Ghabril, Marwan; Sandrasegaran, Kumar; Nguyen, James; Caffrey, Helena; Liangpunsakul, Suthat; Lumeng, Lawrence; Kwo, Paul; Chalasani, Naga.

In: American Journal of Gastroenterology, Vol. 106, No. 5, 05.2011, p. 899-906.

Research output: Contribution to journalArticle

Berman, Kenneth ; Tandra, Sweta ; Vuppalanch, Raj ; Ghabril, Marwan ; Sandrasegaran, Kumar ; Nguyen, James ; Caffrey, Helena ; Liangpunsakul, Suthat ; Lumeng, Lawrence ; Kwo, Paul ; Chalasani, Naga. / Hepatic and extrahepatic cancer in cirrhosis : A longitudinal cohort study. In: American Journal of Gastroenterology. 2011 ; Vol. 106, No. 5. pp. 899-906.
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T2 - A longitudinal cohort study

AU - Berman, Kenneth

AU - Tandra, Sweta

AU - Vuppalanch, Raj

AU - Ghabril, Marwan

AU - Sandrasegaran, Kumar

AU - Nguyen, James

AU - Caffrey, Helena

AU - Liangpunsakul, Suthat

AU - Lumeng, Lawrence

AU - Kwo, Paul

AU - Chalasani, Naga

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