ASSOCIATION BETWEEN ALCOHOL-RELATED LIVER CIRRHOSIS AND LATE STAGES AT DIAGNOSIS OF HEPATOCELLULAR CARCINOMA
DOI:
https://doi.org/10.22551/bbvmet60Abstract
Hepatocellular carcinoma (HCC) is a major complication of liver cirrhosis (LC), and its prognosis is highly dependent on the stage at diagnosis. Alcohol-related liver disease (ALD) is an increasing cause of cirrhosis worldwide, but its impact on the stage of HCC diagnosis remains unclear. Aim of the study: to evaluate the stage at which HCC is diagnosed and assess whether alcohol-related cirrhosis predisposes patients to a more advanced-stage presentation. Materials and methods: We conducted a retrospective observational study of 152 patients diagnosed with HCC at a tertiary center between January 2022 and December 2023. Patients were classified by cirrhosis etiology (alcohol-related vs. viral hepatitis-related) and categorized by HCC stage at diagnosis according to the 2022 Barcelona Clinic Liver Cancer (BCLC) classification. For analysis, patients were grouped based on curative treatment eligibility: curative stages (BCLC 0-A and selected B1 cases) and non-curative stages (BCLC B2-B3, C, and D). Results: Among the 152 patients analyzed, 54 (35.5%) had alcohol-related cirrhosis, and 96 (63.2%) had viral hepatitis-related cirrhosis. At diagnosis, no patients were identified at the very early stage (BCLC 0), while 18.4% were diagnosed at a curative stage and 81.6% at a non-curative stage. Notably, nearly half of all patients (46%) presented at the terminal stage (BCLC D). The proportion of patients diagnosed at a curative stage was significantly lower in those with alcohol-related cirrhosis (7.4%) compared to those with viral hepatitis-related cirrhosis (24%) (p = 0.01). Multivariate analysis confirmed that alcohol-related cirrhosis was independently associated with a higher likelihood of non-curative stage diagnosis. Conclusions: Patients with alcohol-related cirrhosis are significantly more likely to be diagnosed with HCC at a non-curative stage compared to those with viral hepatitis-related cirrhosis. This disparity underscores the need for improved HCC surveillance strategies in this high-risk population, including better patient engagement, integration of hepatology with addiction services, and enhanced screening adherence programs. Addressing these challenges could facilitate earlier diagnosis and improve treatment opportunities for patients with alcohol-related cirrhosis.
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