Incidence of hepatocellular carcinoma in outpatients with cirrhosis in Brazil: A 10-year retrospective cohort study.

Autor:	Appel-da-Silva MC; Marcelo Campos Appel-da-Silva, Suelen Aparecida da Silva Miozzo, Isabella de Azevedo Dossin, Cristiane Valle Tovo, Angelo Alves de Mattos, Graduate Program: Hepatology, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, RS 900150-170, Brazil., Miozzo SA; Marcelo Campos Appel-da-Silva, Suelen Aparecida da Silva Miozzo, Isabella de Azevedo Dossin, Cristiane Valle Tovo, Angelo Alves de Mattos, Graduate Program: Hepatology, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, RS 900150-170, Brazil., Dossin IA; Marcelo Campos Appel-da-Silva, Suelen Aparecida da Silva Miozzo, Isabella de Azevedo Dossin, Cristiane Valle Tovo, Angelo Alves de Mattos, Graduate Program: Hepatology, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, RS 900150-170, Brazil., Tovo CV; Marcelo Campos Appel-da-Silva, Suelen Aparecida da Silva Miozzo, Isabella de Azevedo Dossin, Cristiane Valle Tovo, Angelo Alves de Mattos, Graduate Program: Hepatology, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, RS 900150-170, Brazil., Branco F; Marcelo Campos Appel-da-Silva, Suelen Aparecida da Silva Miozzo, Isabella de Azevedo Dossin, Cristiane Valle Tovo, Angelo Alves de Mattos, Graduate Program: Hepatology, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, RS 900150-170, Brazil., de Mattos AA; Marcelo Campos Appel-da-Silva, Suelen Aparecida da Silva Miozzo, Isabella de Azevedo Dossin, Cristiane Valle Tovo, Angelo Alves de Mattos, Graduate Program: Hepatology, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, RS 900150-170, Brazil.
Jazyk:	angličtina
Zdroj:	World journal of gastroenterology [World J Gastroenterol] 2016 Dec 14; Vol. 22 (46), pp. 10219-10225.
DOI:	10.3748/wjg.v22.i46.10219
Abstrakt:	Aim: To determine the incidence of hepatocellular carcinoma (HCC) and the impact of HCC surveillance on early diagnosis and survival of cirrhotic outpatients. Methods: In this retrospective cohort study, cirrhotic outpatients undergoing HCC surveillance between March 2005 and March 2014 were analyzed. Exclusion criteria were HIV coinfection; previous organ transplantation; diagnosis of HCC at first consultation; missing data in the medical chart; and less than 1 year of follow-up. Surveillance was carried out every six months using ultrasound and serum alpha-fetoprotein determination. Ten-year cumulative incidence and survival were estimated through Kaplan-Meier analysis. Results: Four hundred and fifty-three patients were enrolled, of which 57.6% were male. Mean age was 55 years. Hepatitis C virus and heavy use of alcohol were the main etiologic agents of cirrhosis. HCC was diagnosed in 75 patients (16.6%), with an estimated cumulative incidence of 2.6% in the 1 st year, 15.4% in the 5 th year, and 28.8% in the 10 th year. Median survival was estimated at 17.6 mo in HCC patients compared to 234 mo in non-HCC patients ( P < 0.001). Early-stage HCC was more often detected in patients who underwent surveillance every 6 mo or less ( P = 0.05). However, survival was not different between patients with early stage vs non-early stage tumors [HR = 0.54 (0.15-1.89), P = 0.33]. Conclusion: HCC is a frequent complication in patients with cirrhosis and adherence to surveillance programs favors early diagnosis. Competing Interests: Conflict-of-interest statement: The authors state no conflicts of interest. No financial support was provided for the study.
Databáze:	MEDLINE
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