Session Title: Category 2b. CIRRHOSIS AND ITS COMPLICATIONS: b. CLINICAL ASPECTS
Presentation Date: Apr 15, 2010
DE NOVO EXTRAHEPATIC MALIGNANCIES IN A COHORT OF CIRRHOTIC PATIENTS
M. Montealegre Barrejon*, J.M. Moreno Planas, A. Caramuto Martins, A.B. Galera Rodenas, E. Cascales Martinez, M. Vargas Travaglini, D.F. Garcia Nuñez, A.J. Velasco Valcarcel, M.D.M. Vicente Gutiérrez, R. Pérez Flores
Aparato Digestivo, Complejo Hospitalario Universitario de Albacete, Albacete, Spain. *firstname.lastname@example.org
Background, aims: There are few series describing extrahepatic malignancies in cirrhotic patients. In our research we found only one paper approaching these aspects, with a multidisciplinary management of these patients.
To describe de novo extrahepatic malignancies in cirrhotic patients, special attention to those situated in superior air-digestive tract and lung because of the high percentage of alcoholic cirrhosis and smokers.
Methods: An observational study of a cohort of cirrhotic patients was carried out by registrating their clinical history data and out-hospital follow-up, included consecutively from august 2005 until the present, describing causes of cirrhosis, alcohol intake, smoking, and the appearance of de novo extrahepatic malignancies.
Results: 158 patients were included (79% men, 20,9% women), 69,6% referred alcohol intake. The main causes of hepatic cirrhosis were alcoholic (60.8%), viral (24,5%), and mixed with alcohol intake (1,8%). An alcohol intake of more than 80 gr per day was registrated in 62% of the patients (media 151gr/day +/- 90gr). 37.3% of the patients were active smokers (24,% were ex-smokers), media of 15-30 cigarrettes per day. Throughout a period of 34 (3-100) months of follow up, de novo extrahepatic malignancies were observed in 11 patients (6,9% of the total of cirrhotic patients): 3 lung cancers (localized microcitic carcinoma, radiotherapy; epidermoid carcinoma stage Ib, surgical treatment; and epidermoid carcinoma stage IV, chemotherapy); 4 ORL cancers (locally advanced oropharynx T4 N3 MX; hypopharynx T3 N2 M0, both with chemo/radiotherapy, vocal cord T1 N0 M0, amygdala T1 N2b M0, both with radical radiotherapy); 1 breast cancer (T1 N0 M0), mastectomy and radiotherapy; 2 Non Hodgkin lymphomas (lung, chemotherapy; cutaneous) and an espinocelular carcinoma, surgical treatment. Cirrhosis was of alcoholic cause in all cases except in NHL (HCV). In patients with ORL and lung cancers there was also history of smoking habit.
Conclusions: Although the results obtained in this study have not been compared with the general population, they seem to recommend a multidisciplinary management of cirrhotic patients, because of the existence of demographic characteristics and risk factors which can contribute to develope other diseases, and mostly important in patients who could be waiting for liver trasplant.