From the Journals

Survival worse with alcohol-related HCC, compared with other types

 

Key clinical point: Patients with HCC from alcohol or other causes had better survival if they were under surveillance for cirrhosis.

Major finding: Adjusted median overall survival was 5.7 months with alcohol-related HCC versus 9.7 months for nonalcoholic HCC (P = .0002).

Study details: Analysis of data from a prospective observational cohort of 1,207 patients with HCC in France.

Disclosures: The study was supported by the Association Nationale des Hepato-Gastroenterologues des Hopitaux Généraux group and Roche Pharmaceuticals. Dr. Constentin did not report conflicts of interest. Several of her coauthors reported personal fees from various companies outside the submitted work.

Source: Costentin CE at al. Cancer. doi: 10.1002/cncr.31215.


 

FROM CANCER

Hepatocellular carcinoma (HCC) related to alcohol use tends to be diagnosed at a later stage than HCC from other causes, which contributes to reduced overall survival among patients with alcoholic HCC, investigators in a prospective French study said.

Among 894 patients diagnosed with HCC, the adjusted median overall survival was 5.7 months for those with alcoholic HCC, compared with 9.7 months for those with nonalcoholic HCC (P = .0002), reported Charlotte E. Costentin, MD, of the Hopital Henri Mondor in Creteil, France, and colleagues.

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“Various assumptions can be made to explain why patients with alcohol-related HCC have reduced survival in comparison with patients with non–alcohol-related HCC: a diagnosis at a later stage due to lower rates of HCC screening, worse liver function and/or ongoing alcohol consumption preventing curative options, and discrimination against alcoholic patients leading to less aggressive treatment options,” they wrote in a study published online in Cancer.

The investigators looked at data on clinical features and treatment allocation of patients in the CHANGH cohort (cohorte de Carcinomes Hepatocelulaires de l’Association des hepato-Gastroenterologues des Hopitaux Generaux), a prospective, observational cohort study.

Of 1,207 patients with complete data, 582 had isolated alcohol-related HCC, and 312 had non–alcohol-related HCC, which was caused by either nonalcoholic fatty liver, hepatitis C infections, hepatitis B infections, hemochromatosis, or other etiologies.

As noted before, the median overall survival adjusted for lead-time bias (the length of time between the detection of a disease and its usual diagnosis) was significantly shorter for patients with alcohol-related HCC.

In univariate analysis, alcohol-related HCC, compared with non–alcohol-related HCC, was an independent risk factor for worse overall survival (hazard ratio, 1.39; P = .0002).

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