Alcohol abstinence lowers HCC risk in patients with cirrhosis

Abstinence from alcoholic drinks reduces the risk of hepatocellular carcinoma (HCC) in patients with alcohol-related liver cirrhosis, but not in those with a history of decompensated disease, reveals a study.

“This finding emphasizes the need for an early diagnosis of alcohol-related liver disease and for implementing strategies leading to an increase in the rate of achieving and maintaining abstinence among this population,” the authors said.

A total of 727 patients with alcohol-related cirrhosis included in a surveillance programme for the early detection of HCC and prospectively followed were included in this analysis. Of these, 247 had compensated disease and 480 had previous decompensation.

The authors then recorded baseline clinical and biological parameters, as well as alcohol consumption, during follow-up. Abstinence was defined as the absence of any alcohol use.

During a median follow-up of 54 months, 354 patients (48.7 percent) remained abstinent and 104 developed HCC (2.3 per 100 person-years).

Age, male gender, and aspartate aminotransferase were independently associated with HCC risk among patients with previous decompensation, although abstinence was not associated with a reduced risk (hazard ratio [HR], 0.95, 95 percent confidence interval [CI], 0.59–1.52).

For patients without previous decompensation, the risk of HCC correlated independently with prothrombin activity and abstinence.

Notably, alcohol abstinence resulted in a significant decrease in the risk of developing tumour (HR, 0.35, 95 percent CI, 0.13–0.94).

These results persisted even after applying a competing risk analysis where death and liver transplantation were considered as competing events.