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29.11.2018 | Original Article—Liver, Pancreas, and Biliary Tract Open Access

A nationwide survey on non-B, non-C hepatocellular carcinoma in Japan: 2011–2015 update

Zeitschrift:
Journal of Gastroenterology
Autoren:
Ryosuke Tateishi, Koji Uchino, Naoto Fujiwara, Tetsuo Takehara, Takeshi Okanoue, Masataka Seike, Hitoshi Yoshiji, Hiroshi Yatsuhashi, Masahito Shimizu, Takuji Torimura, Mitsuhiko Moriyama, Isao Sakaida, Hiroyuki Okada, Tetsuhiro Chiba, Makoto Chuma, Kazuhiko Nakao, Hajime Isomoto, Yutaka Sasaki, Shuichi Kaneko, Tsutomu Masaki, Kazuaki Chayama, Kazuhiko Koike
Wichtige Hinweise

Electronic supplementary material

The online version of this article (https://​doi.​org/​10.​1007/​s00535-018-1532-5) contains supplementary material, which is available to authorized users.

Abstract

Background

We previously reported that the incidence of hepatocellular carcinoma (HCC) with non-viral etiologies increased rapidly between 1991 and 2010 in Japan.

Methods

To update this investigation, we enrolled patients who were initially diagnosed as having non-B, non-C HCC at participating hospitals between 2011 and 2015. In addition to the patient characteristics investigated in the previous report, we also investigated the duration of alcohol consumption. The overall survival rate was analyzed using the Kaplan–Meier method, and the hazard function against the body mass index (BMI) was plotted using cubic splines.

Results

A total of 2087 patients were enrolled. The proportion of patients with non-viral etiologies has continued to increase from 10.0% in 1991 to 32.5% in 2015. Patients were also older (median ages, 70–73 years) and more obese (median BMIs, 23.9–24.2 kg/m2), and the proportions of patients with diabetes mellitus (46.1% to 51.6%), hypertension (42.7% to 58.6%), dyslipidemia (14.6% to 22.9%), and fatty liver (24.0% to 28.8%) had all increased significantly. There was a significant inverse relationship between the duration and the amount of daily alcohol consumption. The improvement in the overall survival was relatively small, with a decreased proportion of patients under surveillance (41.3% to 31.6%). A hazard function plot showed a curve similar to that in our previous report, with a lowest hazard of ~ 26 kg/m2.

Conclusions

The proportion of HCC patients with non-viral etiologies continues to increase in Japan. Lifetime total amount of alcohol consumption may be a risk factor.

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Zusatzmaterial
Supplementary material 1 GGT, AST, and ALT values and FIB-4 indices between patients with at least 6 months of practicing moderation in drinking and controls who continued drinking, matched for gender and daily amount of alcohol intake. The difference was most prominent for GGT, followed by AST. The difference was marginally significant for ALT, and no difference in the FIB-4 indices was observed. Abbreviations: AST, aspartate aminotransferase; ALT, alanine aminotransferase; FIB-4, fibrosis-4; GGT, γ-glutamyltransferase. (TIFF 626 kb)
535_2018_1532_MOESM1_ESM.tif
Supplementary material 2 Presence of prescriptions for the treatment of (A) diabetes, (B) hypertension, and (C) dyslipidemia. Abbreviations: ACEI, angiotensin-converting-enzyme inhibitors; αGI, alpha-glucosidase inhibitors; ARB, angiotensin II receptor blockers; BG, biguanide; CCB, calcium channel blockers; DIU, diuretics; DPP-4, dipeptidyl peptidase-4 inhibitors; EZT, ezetimibe; FIB, fibrates; GLN, glinides; GLP-1, glucagon-like peptide-1 agonists; ω3FA, omega-3 fatty acid; SU, sulfonylureas; SGLT-2, sodium/glucose cotransporter 2 inhibitors; TZD, thiazolidinediones. (TIFF 525 kb)
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Supplementary material 3 (TIFF 388 kb)
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Supplementary material 4 (TIFF 368 kb)
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