Hepatitis B- and C-associated hepatocellular carcinoma in a large U.S. cancer center: Do clinicopathologic features or patient outcomes differ by the potentially causative viruses?

Gastrointestinal (Noncolorectal) Cancer
Session Type and Session Title: 
Clinical Science Symposium, To Lump or To Split: Molecular, Anatomic, and Etiologic Subtyping of Noncolorectal Gastrointestinal Malignancies and Potential Therapeutic Implications
Abstract Number: 


J Clin Oncol 33, 2015 (suppl; abstr 4011)
Marc Isamu Uemura, Ahmed Omar Kaseb, Reham Abdel-Wahab, Kanwal Pratap Singh Raghav, Gehan Botrus, Ernest Hawk, Robert A. Wolff, Jeffrey Morris, Manal Hassan; The University of Texas MD Anderson Cancer Center, Houston, TX; Department of Gastrointestinal Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX

Abstract Disclosures


Background: Hep B virus (HBV) and hep C virus (HCV) are the main viral causes of hepatocellular carcinoma (HCC) development and are responsible for ~50% of USA cases. Because HBV is a DNA virus (Hepadna family) and HCV is an RNA virus (flavivirus family), it is unclear whether such virologic differences influence clinico-pathologic features of HCC or patient outcomes. We evaluated such differences in a large-scale, single-center study. Methods: Between 1992 to 2011, 815 HCC patients (HCV = 472, HBV = 343) were referred for treatment at the Univ. of Texas MD Anderson Cancer Center. Under IRB approval, detailed patient characteristics at time of diagnosis were documented. Chi-square tests were used to assess the significance of differences in the distributions of categorical variables between HBV and HCV groups. Median survival (mos.) was calculated using Kaplan Meier product-limit method and survival rates were compared using the log rank test. Results: 63% of patients were Texas residents with male to female ratio = 3:1. Patients with HBV were more likely to develop HCC at younger age than HCV patients, with poorly differentiated tumor (PDT), portal thrombosis (PT), larger tumor size (> 5 cm), extensive liver involvement (> 50%), high alpha-fetoprotein, and advanced CLIP stage (3-6). On the other hand, patients with HCV were more likely to exhibit underlying cirrhosis, have a history of greater alcohol and cigarette use, and had higher co-occurrence of diabetes mellitus (DM). One-year survival rates were similar between both groups (43.3%) and median survivals were 10.9 and 9.3 mos. for HCV and HBV, respectively (P = 0.9). Conclusions: Significant clinico-pathologic variations exist in HCC patients associated with HCV vs HBV, which may impact patients’ eligibility for treatment, but not prognosis.

Mean +/- SD (age) and proportion (%) of HCC characteristics in HCV and HBV.

AgePDTPT> 5cm> 50%CirrhosisCLIP(3-6)SmokeAlcoholDMSTTLATAFP
HCV61.3 ± 1018.830.235.226.68636.97370.123.527.527.417894 ± 4662
HBV57.4 ± 1426.535.749.442.959.54456.449.318.336.917.255708 ± 1095
p<.< .001< .001.03< .001< .001.05< .001< .001< .001