Epidemiology of HCC in Brazil: incidence and risk factors in a ten-year cohort

Background and aim. The lack of information about hepatocellular carcinoma (HCC) in Brazil weakens health policy in preventing deaths from the illness. The aim of this study was to establish the cumulative incidence and the risk factors for hepatocellular carcinoma development in patients under a surveillance program. Material and methods. 884 patients with compensated cirrhosis were prospectively followed up for at least five years, from August 1998 until August 2008, with at least one annual ultrasonography liver examination and serum alpha fetoprotein (AFP) measurement. Results. Among 884 patients, 72 (8.1%) developed a tumor with a median follow up of 21.4 months. In the hepatocellular carcinoma group, hepatitis C virus infection was the major etiological factor (65.3%), 56.9% (41/72) were male and the mean average age was 57 +/- 10 years. The annual incidence of hepatocellular carcinoma was 2.9%. 79.2% (57/72) of HCCs were detected within Milan Criteria, and the mean survival time was 52.3 months, significantly higher than for those outside Milan, with a mean time of 40.6 months (p = 0.0003). Conclusion. The annual incidence of HCC among this large series of Brazilian cirrhotic patients was around 2.9% with a detection rate of 8.1%, or a cumulative incidence rate over five years of 14.3%. The three variables related to HCC risk were low serum albumin [HR: 0.518 (0.46-0.78)], high AFP > 20 ng/mL [HR: 3.16 (1.86-5.38)], and ethnicity (Brazilian-East Asian descendants vs. other mixed Brazilian ethnicities) [HR: 2.86 (1.48-5.53)].

Palavras-chave

Ultrasonography, Milan criteria, Risk factors, Hepatocellular carcinoma, Surveillance

URI

https://observatorio.fm.usp.br/handle/OPI/8435

Referências

Bruix J, 2011, HEPATOLOGY, V53, P1020, DOI 10.1002/hep.24199
Carrilho FJ, 2010, CLINICS, V65, P1285, DOI 10.1590/S1807-59322010001200010
Chagas AL, 2009, BRAZ J MED BIOL RES, V42, P958, DOI 10.1590/S0100-879X2009005000019
Coelho GR, 2009, TRANSPL P, V41, P1740, DOI 10.1016/j.transproceed.2009.01.104
Colombo M., 1995, VIRAL HEPATITIS REV, V1, P65
Davila JA, 2010, HEPATOLOGY, V52, P132, DOI 10.1002/hep.23615
El-Serag HB, 1999, NEW ENGL J MED, V340, P745, DOI 10.1056/NEJM199903113401001
El-Serag HB, 2002, HEPATOLOGY, V36, pS74, DOI 10.1053/jhep.2002.36807
European Association For The Study Of The Liver
European Organisation For Research And Treatment Of Cancer, 2012, J HEPATOL, V56, P908
Fattovich G, 2004, GASTROENTEROLOGY, V127, pS35, DOI 10.1053/j.gast.2004.09.014
Goncalves Carlos S., 1997, Revista do Instituto de Medicina Tropical de Sao Paulo, V39, P165
Jan CF, 2005, J GASTROEN HEPATOL, V20, P521, DOI 10.1111/j.1400-1746.2004.03602.x
Kamath PS, 2001, HEPATOLOGY, V33, P464, DOI 10.1053/jhep.2001.22172
Kikuchi LOO, 2009, J CLIN GASTROENTEROL, V43, P191, DOI 10.1097/MCG.0b013e31817ff199
Kudo M, 2011, DIGEST DIS, V29, P339, DOI 10.1159/000327577
Lee E, 2013, CLIN GASTROENTEROL H, V11, P437, DOI 10.1016/j.cgh.2012.11.029
Mazzaferro V, 1996, NEW ENGL J MED, V334, P693, DOI 10.1056/NEJM199603143341104
Michitaka K, 2010, J GASTROENTEROL, V45, P86, DOI 10.1007/s00535-009-0128-5
Ripoll C, 2009, J HEPATOL, V50, P923, DOI 10.1016/j.jhep.2009.01.014
Sangiovanni A, 2004, GASTROENTEROLOGY, V126, P1005, DOI 10.1053/j.gastro.2003.12.049
Singal A, 2009, ALIMENT PHARM THER, V30, P37, DOI 10.1111/j.1365-2036.2009.04014.x
Venook AP, 2010, ONCOLOGIST, V15, P5, DOI 10.1634/theoncologist.2010-S4-05
Yang JD, 2010, NAT REV GASTRO HEPAT, V7, P448, DOI 10.1038/nrgastro.2010.100

Coleções

Artigos e Materiais de Revistas Científicas - FM/MGT
Artigos e Materiais de Revistas Científicas - FM/MPT
Artigos e Materiais de Revistas Científicas - HC/ICHC
Artigos e Materiais de Revistas Científicas - LIM/07
Artigos e Materiais de Revistas Científicas - LIM/14
Artigos e Materiais de Revistas Científicas - ODS/03

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