Abstinence does not reduce HCC risk in alcoholic-related cirrhosis
PARIS — Alcohol abstinence did not reduce the risk for hepatocellular carcinoma among patients with Child-Pugh class A or B alcohol-related cirrhosis, according to a presentation at the International Liver Congress 2018.
“Our goal was to investigate if abstinence reduces HCC risk in a series of patients with alcoholic liver cirrhosis who were included in an HCC surveillance program,” Andrés Castano-Garcia, MD, PhD, from the Hospital Universitario Central de Asturias in Spain, said in his presentation. “Abstinence was defined as the absence of any alcohol consumption from inclusion and established based on interviews with patients.”
Castano-Garcia and colleagues enrolled 602 patients with Child-Pugh class A or B alcohol-related cirrhosis in the surveillance program. Mean patient age was 55 years, 83% had a history of cirrhotic complications, and 79% had varices. Over a mean follow-up of 77 months, 298 patients remained abstinent. Ninety-three patients developed HCC for a mean annual incidence of 2.4% and cumulative probability of 23% at 10 years and 45% at 20 years.
The researchers found no difference in the probability for HCC between patients who remained abstinent and those who did not.
Factors associated with an increased risk for HCC included male sex (OR = 2.52; 95% CI, 1.26-5.05), age than 55 years (OR = 2.15; 95% CI, 1.39-3.35) and platelet count (PTC) less than 145 x 103/mm3 (OR = 1.94; 95% CI, 1.11-3.4).
Final analysis showed that abstinence was not related to the risk for HCC (OR = 0.96; 95% CI, 0.61-1.49).
In a subgroup of abstinent patients, the development of HCC correlated with age older than 55 years (P = .038), and PTC less than 145 x 103/mm3 (P = .022) and previous cirrhosis complications (P = .048). In patients who did not remain abstinent, HCC risk correlated with male sex (P = .032), age older than 55 years (P = .005) and PTC less than 145 x 103/mm3 (P = .025).
“These results highlight the need for early diagnosis of alcoholic liver disease as well as for the development of effective drugs for HCC,” Castano-Garcia concluded. – by Talitha Bennett
For more information:
Castano-Garcia A, et al. Abstract PS-064. Presented at: International Liver Congress; Apr. 11-15, 2018; Paris, France.
Disclosure: Healio Gastroenterology and Liver Disease could not confirm financial relationships at time of publication.
Editor’s note: This item has been updated with clarifications from the presenter.