Digestive Diseases and Sciences

, Volume 59, Issue 1, pp 192–200 | Cite as

Clinical Presentation and Survival of Asian and Non-Asian Patients with HCV-Related Hepatocellular Carcinoma

  • Benjamin Yip
  • James M. Wantuck
  • Lily H. Kim
  • Robert J. Wong
  • Aijaz Ahmed
  • Gabriel Garcia
  • Mindie H. Nguyen
Original Article

Abstract

Background and Aim

Hepatitis C virus (HCV) is an important cause of hepatocellular carcinoma (HCC) in Asians; however, it is often overlooked due to the high prevalence of hepatitis B virus in Asians. This study examines HCV-related HCC in Asians.

Methods

We conducted a retrospective cohort study of 792 consecutive Asian (n = 220) and non-Asian (n = 572) patients with HCV-related HCC identified at Stanford University Medical Center using International Classification of Diseases-9 diagnosis between July 1996 and June 2012.

Results

Asian patients were much older [66 (38–88) vs. 56 (31–87) years, P < 0.0001] and more likely to be female (33 vs. 19 %, P < 0.0001). A larger proportion of Asians were diagnosed with HCC within 2 years of HCV diagnosis (35 vs. 20 %, P = 0.001). Asian patients were more likely to undergo palliative therapy (46 vs. 28 %) and less likely to be listed for liver transplantation (20 vs. 48 %, P < 0.001), despite similar rates of meeting Milan criteria (52 vs. 58 %, P = 0.16). Overall, there was a trend for higher median survival rates in Asians (30 vs. 21 months, P = 0.091). Asians had higher long-term survival with palliative therapy only (5-year survival: 28 vs. 10 %, P < 0.0001); however, survival was similar among patients listed for liver transplantation.

Conclusions

There were distinct differences in clinical presentations of Asian and non-Asian patients with HCV-related HCC. Asians with HCV-related HCC are less likely to undergo liver transplantation and more likely to have delayed HCV diagnosis. Improved strategies in HCV screening in Asians are needed, as it may lead to earlier diagnosis and treatment of HCV infection and possible prevention of HCC development.

Keywords

Ethnicity Transplant Liver cancer Chronic hepatitis C 

Abbreviations

AASLD

American Association for the Study of Liver Diseases

BCLC

Barcelona clinic liver cancer

BMI

Body mass index

CPT

Child–Turcotte–Pugh

HBV

Hepatitis B virus

HCC

Hepatocellular carcinoma

HCV

Hepatitis C virus

HR

Hazards ratio

ICD-9

International Classification of Diseases-9

MELD

Model for end-stage liver disease

OR

Odds ratio

UCSF

University of California, San Francisco

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Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Benjamin Yip
    • 1
    • 2
  • James M. Wantuck
    • 3
  • Lily H. Kim
    • 4
  • Robert J. Wong
    • 2
  • Aijaz Ahmed
    • 2
  • Gabriel Garcia
    • 2
  • Mindie H. Nguyen
    • 2
  1. 1.Medical SchoolEastern Virginia Medical SchoolNorfolkUSA
  2. 2.Division of Gastroenterology and HepatologyStanford University Medical CenterPalo AltoUSA
  3. 3.Department of MedicineStanford University Medical CenterPalo AltoUSA
  4. 4.Stanford UniversityPalo AltoUSA

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