Long-term Outcomes of Patients With Primary Biliary Cirrhosis and Hepatocellular Carcinoma

Mohamad H. Imam, Marina G. Silveira, Emmanouil Sinakos, Andrea A. Gossard, Roberta Jorgensen, Jill Keach, Alisha C. DeCook, Keith Lindor

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Background & Aims: Hepatocellular carcinoma (HCC) is an aggressive tumor that frequently develops in patients with primary biliary cirrhosis (PBC). We determined the mortality of patients with PBC who develop HCC, and which interventions (surgery, radiofrequency ablation, chemoembolization, alcohol injection, or transplantation) increase survival times. We investigated whether the Milan criteria predict outcomes of these patients and are effective in selection for liver transplantation. Methods: We evaluated data from 38 patients who had a confirmed diagnosis of PBC and HCC between March 1993 and February 2011. Patients were grouped based on whether or not they met the Milan criteria. Survival was assessed using the Kaplan-Meier analysis. Results: Eighteen of the 38 patients (47.3%) died during the follow-up period; 49.4% survived for 5 years and 31.7% survived for 10 years. Thirty-five patients (92.0%) underwent one or a combination of interventions. Liver transplantation improved survival (risk ratio, 0.06; P < .0001), whereas surgery approached significance in causing deterioration (risk ratio, 2.87; P =.07). Mortality did not appear to be affected by meeting the Milan criteria (P =.84). Conclusions: Five- and 10-year survival times for patients with PBC who developed HCC were 49.4% and 31.7%, respectively. Patients who meet the Milan criteria receive liver transplantation as often as those who do not; we did not observe a difference in survival time between groups. Patients with PBC who develop HCC appear to benefit from aggressive therapies.

Original languageEnglish (US)
Pages (from-to)182-185
Number of pages4
JournalClinical Gastroenterology and Hepatology
Volume10
Issue number2
DOIs
StatePublished - Feb 2012
Externally publishedYes

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Biliary Liver Cirrhosis
Hepatocellular Carcinoma
Survival
Liver Transplantation
Odds Ratio
Mortality
Kaplan-Meier Estimate
Transplantation
Alcohols
Injections

Keywords

  • Cancer
  • Cholestatic
  • Liver
  • Prognostic Factors
  • Treatment

ASJC Scopus subject areas

  • Gastroenterology
  • Hepatology

Cite this

Long-term Outcomes of Patients With Primary Biliary Cirrhosis and Hepatocellular Carcinoma. / Imam, Mohamad H.; Silveira, Marina G.; Sinakos, Emmanouil; Gossard, Andrea A.; Jorgensen, Roberta; Keach, Jill; DeCook, Alisha C.; Lindor, Keith.

In: Clinical Gastroenterology and Hepatology, Vol. 10, No. 2, 02.2012, p. 182-185.

Research output: Contribution to journalArticle

Imam, MH, Silveira, MG, Sinakos, E, Gossard, AA, Jorgensen, R, Keach, J, DeCook, AC & Lindor, K 2012, 'Long-term Outcomes of Patients With Primary Biliary Cirrhosis and Hepatocellular Carcinoma', Clinical Gastroenterology and Hepatology, vol. 10, no. 2, pp. 182-185. https://doi.org/10.1016/j.cgh.2011.09.013
Imam, Mohamad H. ; Silveira, Marina G. ; Sinakos, Emmanouil ; Gossard, Andrea A. ; Jorgensen, Roberta ; Keach, Jill ; DeCook, Alisha C. ; Lindor, Keith. / Long-term Outcomes of Patients With Primary Biliary Cirrhosis and Hepatocellular Carcinoma. In: Clinical Gastroenterology and Hepatology. 2012 ; Vol. 10, No. 2. pp. 182-185.
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AB - Background & Aims: Hepatocellular carcinoma (HCC) is an aggressive tumor that frequently develops in patients with primary biliary cirrhosis (PBC). We determined the mortality of patients with PBC who develop HCC, and which interventions (surgery, radiofrequency ablation, chemoembolization, alcohol injection, or transplantation) increase survival times. We investigated whether the Milan criteria predict outcomes of these patients and are effective in selection for liver transplantation. Methods: We evaluated data from 38 patients who had a confirmed diagnosis of PBC and HCC between March 1993 and February 2011. Patients were grouped based on whether or not they met the Milan criteria. Survival was assessed using the Kaplan-Meier analysis. Results: Eighteen of the 38 patients (47.3%) died during the follow-up period; 49.4% survived for 5 years and 31.7% survived for 10 years. Thirty-five patients (92.0%) underwent one or a combination of interventions. Liver transplantation improved survival (risk ratio, 0.06; P < .0001), whereas surgery approached significance in causing deterioration (risk ratio, 2.87; P =.07). Mortality did not appear to be affected by meeting the Milan criteria (P =.84). Conclusions: Five- and 10-year survival times for patients with PBC who developed HCC were 49.4% and 31.7%, respectively. Patients who meet the Milan criteria receive liver transplantation as often as those who do not; we did not observe a difference in survival time between groups. Patients with PBC who develop HCC appear to benefit from aggressive therapies.

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