Etiologic fractions in patients of hepatocellular carcinoma in India with and without a background of cirrhosis: a multi-centric study

Autor: Tushar Prabhakar, Kanica Kaushal, Manya Prasad, Ekta Gupta, Ajit Sood, Ajay Jain, Akash Shukla, Ashish Goel, Ajay Duseja, Anoop Saraya, Samir Shah, Guresh Kumar, Shiv Kumar Sarin
Rok vydání: 2023
Předmět:
Zdroj: Hepatology International. 17:745-752
ISSN: 1936-0541
1936-0533
DOI: 10.1007/s12072-023-10498-w
Popis: Background: Hepatocellular cancer (HCC) typically arises in the background of cirrhosis. Its epidemiology has been changing due to availability of antivirals, changing life-styles and early detection. We undertook a multicentric national sentinel surveillance for liver cirrhosis and HCC to assess the attributable risk factors for development of HCC, both with and without a background of cirrhosis. Methods: Data from January 2017 till August 2022 from hospital-based records of eleven participating centres was included. Diagnosed cases of cirrhosis [radiological (multiphase and/or histopathological] and HCC [as per AASLD 2018] were included. History of significant alcohol intake was elicited by AUDIT-C questionnaire. Results: Altogether 5798 enrolled patients were assessed, of which 2664 patients had HCC. The mean age was 58.2±11.7 years and 84.3% (n=2247) were males. Diabetes was found in over a third of those with HCC (n=1032;39.5%). The most common etiology of HCC was NAFLD (n=927;35.5%) followed by viral hepatitis B and C and harmful levels of alcohol. Among those with HCC, 27.9% (n=744) had no cirrhosis. Higher proportion of cirrhotic HCC patients had alcohol as an etiological factor as compared to non-cirrhotic (17.5% Vs 4.7%, p= 60 years, 1.372 times for males and 3.472 times for harmful alcohol consumption. Those with NAFLD were 1.553 times more likely to develop non-cirrhotic HCC. Conclusion: This large multi-centric study demonstrates that NAFLD is the most important risk factor for development of both cirrhotic and non-cirrhotic HCC in India and has overtaken viral hepatitis. Awareness campaigns and large-scale screening are required to reduce the high burden of NAFLD related HCC in India.
Databáze: OpenAIRE
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