Risk Factors Predict for the Development of Cancer in Patients with Cirrhosis

Risk Factors Predict for the Development of Liver Cancer in Patients with Liver Cirrhosis

According to a recent article published in the journal Hepatology, four separate variables may help predict which patients with cirrhosis of the liver are at a higher risk for developing liver cancer.

Primary liver cancer, sometimes called hepatocellular cancer (HCC), is characterized by cancer that starts in cells of the liver and can spread, through blood and lymph vessels, to different parts of the body. The liver is one of the largest organs in the body and is responsible for over 500 functions, including the secretion of glucose, proteins, vitamins and fats, the production of bile, the processing of hemoglobin and the detoxification of numerous substances.

Individuals with cirrhosis (scarring) of the liver are known to be at an increased risk of developing HCC. Patients with HCC have improved outcomes if their cancer is detected and treated early, before it has had time to spread to several or distant sites in the body. Therefore, many patients with cirrhosis undergo routine ultrasound screenings and testing for the “marker” alpha-fetoprotein (AFP) in their blood to detect the presence of HCC prior to any symptoms. However, determining which patients are at a significant risk for developing HCC is needed so high-risk patients may be more closely monitored while patients at a low risk may safely undergo less frequent screening.

Researchers from Spain recently conducted a clinical study in an attempt to determine if any clinical characteristics could help indicate whether a patient with cirrhosis of the liver is at a higher risk of developing HCC compared to other patients with cirrhosis. The study involved 463 patients with cirrhosis of the liver, 38 of whom ultimately developed HCC. The researchers evaluated several risk factors in this group of patients to establish an association between any variables and the risk of developing HCC. The data indicated that 4 separate variables were associated with an increased risk of developing HCC including age 5 or older, antibodies (an immune response) to hepatitis C, lower platelet (protein that aids the blood in clotting) levels (75 × 103/mm3 or less) and lower prothrombin (test of coagulating ability of the blood) activity (75% or less).

These researchers concluded that the addition of testing of these 4 variables may help indicate which patients with cirrhosis of the liver may be at a higher risk for developing HCC and thus may help to streamline screening efforts for HCC in this group of patients. Patients with cirrhosis of the liver may wish to speak with their physician about the results of this study and the risks and benefits of testing for these 4 risk factors or the participation in a clinical trial further evaluating screening markers or preventive therapies. Two sources regarding information of ongoing clinical trials include the National Cancer Institute (cancer.gov) and www.eCancerTrials.com. eCancerTrials.com also provides personalized clinical trial searches on behalf of patients.

Reference: Velazquez R, Rodriguez M, Navascues C, et al. Prospective analysis of risk factors for hepatocellular carcinoma in patients with liver cirrhosis.

Hepatology. 2003;37:520-527.

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