Hepatocellular Carcinoma Incidence in Alcohol-Associated Cirrhosis: Systematic Review and Meta-analysis - PubMed (original) (raw)
Meta-Analysis
. 2023 May;21(5):1169-1177.
doi: 10.1016/j.cgh.2022.06.032. Epub 2022 Aug 5.
Darren J H Tan 2, Cheng Han Ng 2, Maral Amangurbanova 3, Nancy Sutter 3, Phoebe Wen Lin Tay 2, Wen Hui Lim 2, Jie Ning Yong 2, Ansel Tang 2, Nicholas Syn 2, Mark D Muthiah 4, Eunice X X Tan 4, Shravan Dave 3, Benjamin Tay 5, Abdul M Majzoub 6, Danielle Gerberi 7, Beom Kyung Kim 8, Rohit Loomba 9
Affiliations
- PMID: 35940513
- PMCID: PMC10792532
- DOI: 10.1016/j.cgh.2022.06.032
Meta-Analysis
Hepatocellular Carcinoma Incidence in Alcohol-Associated Cirrhosis: Systematic Review and Meta-analysis
Daniel Q Huang et al. Clin Gastroenterol Hepatol. 2023 May.
Abstract
Background & aims: Alcohol is one of the leading causes of hepatocellular carcinoma (HCC). However, pooled estimates of HCC incidence in alcohol-associated cirrhosis have not been evaluated systematically. We performed a pooled analysis of time-to-event data to provide robust estimates for the incidence of HCC in alcohol-associated cirrhosis.
Methods: Medline, Embase, Cochrane Central Register, Scopus, and Web of Science were searched from inception to August 2021. Individual patient data were reconstructed from published Kaplan-Meier curves, and a pooled analysis of cumulative HCC incidence was performed using a random-effects model.
Results: We screened 5022 articles and included 18 studies (148,333 patients). In the pooled analysis, the cumulative incidence of HCC in alcohol-associated cirrhosis at 1, 5, and 10 years among studies that accounted for the competing risk of death without HCC was 1%, 3%, and 9%, respectively. A secondary analysis by traditional meta-analysis determined that the HCC incidence rate was higher in cohorts enrolled in a HCC surveillance program (18.6 vs 4.8 per 1000 person-years; P = .001) vs those who were not enrolled in a surveillance program. Meta-regression showed that diabetes, smoking, variceal bleeding, and hepatic decompensation were associated with a higher risk of HCC.
Conclusions: Our analysis determined that the 5- and 10- year cumulative risk of HCC in alcohol-associated cirrhosis was 3% and 9%, respectively, with a higher incidence in cohorts that were enrolled in a HCC surveillance program. These data should be validated further in large prospective studies, and may have important implications for HCC screening and surveillance among patients with alcohol-associated cirrhosis.
Keywords: Alcohol; Cirrhosis; Hepatocellular Carcinoma; Incidence.
Copyright © 2023 AGA Institute. Published by Elsevier Inc. All rights reserved.
Conflict of interest statement
These authors disclose the following: Daniel Q. Huang has received funding support from the Singapore Ministry of Health’s National Medical Research Council under its National Medical Research Council (NMRC) Research Training Fellowship (MOH-000595-01).
Figures
Figure 1.
Preferred Reporting Items for Systematic Reviews and Meta-Analyses flowchart of included articles. HCC, hepatocellular carcinoma.
Figure 2.
Cumulative risk of hepatocellular carcinoma (HCC) among patients with alcohol-associated cirrhosis among studies that accounted for competing risk of death without HCC, by reconstructed individual patient data meta-analysis.
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