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Chronic Viral Hepatitis and Hepatocellular Carcinoma

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Abstract

Background

Hepatocellular carcinoma (HCC) is the third leading cause of death from malignancy worldwide, and its increasing incidence parallels rising global rates of hepatitis B (HBV) and hepatitis C (HCV).

Methods

This retrospective review was undertaken to identify differences in the epidemiology and tumor characteristics of 255 patients with HCC due to chronic HBV (n = 105) or HCV (n = 150).

Results

Hepatitis B patients were predominantly Asian (84%), whereas HCV patients were predominantly Caucasian (72%; p < 0.0001). Hepatitis B patients exhibited stronger family histories of liver disease (54%) and HCC (33%), whereas HCV risk factors included blood transfusion (56%), intravenous drug abuse (31%), and alcohol consumption (44%; p < 0.0001 for all comparisons). Pretreatment laboratory values showed lower albumin and platelet levels but higher bilirubin and AST levels in HCV versus HBV patients (p < 0.0001 to 0.01). As cirrhosis was present in nearly all HCV patients, but only in 79% of HBV patients, HCV patients had more stigmata of portal hypertension, including ascites (65%), varices (86%), splenomegaly (77%), and encephalopathy (41%; p < 0.0002 for all comparisons). Although tumors in HBV patients were larger (7.3 cm versus 5.1 cm; p = 0.0001) and more frequently bilobar, the tumor grade, number of tumors, and metastases were similar for both groups. Hepatitis C patients received less treatment, including chemoembolization and surgical resection. The 5-year survival was higher in HBV patients compared to HCV patients (56% versus 36%, p = 0.046).

Conclusions

Patients with HBV- and HCV-related HCC have different epidemiologic, clinical, and survival characteristics. More HCV patients presented with advanced cirrhosis, received less aggressive treatment, and experienced lower 5-year survival.

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Acknowledgments

Financial support was provided through a 2005 Short Term Training Program from the David Geffen School of Medicine at UCLA.

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Authors and Affiliations

  1. Dumont-UCLA Liver Cancer Center, Department of Surgery, David Geffen School of Medicine at UCLA, 650 C.E. Young Drive, South 72-260 CHS, Box 956904, Los Angeles, California, 90095-6904, USA

    Yagil Barazani & Jonathan R. Hiatt

  2. Dumont-UCLA Liver Cancer Center, Department of Surgery, David Geffen School of Medicine at UCLA, 650 C.E. Young Drive, South 77-120 CHS, Box 957054, Los Angeles, California, 90095-7054, USA

    Myron J. Tong & Ronald W. Busuttil

Authors
  1. Yagil Barazani
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  2. Jonathan R. Hiatt
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  3. Myron J. Tong
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  4. Ronald W. Busuttil
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Corresponding author

Correspondence to Jonathan R. Hiatt.

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Barazani, Y., Hiatt, J.R., Tong, M.J. et al. Chronic Viral Hepatitis and Hepatocellular Carcinoma. World J Surg 31, 1245–1250 (2007). https://doi.org/10.1007/s00268-007-9041-3

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