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ASCO 2015: Does Hepatocellular Carcinoma Differ in People with Hepatitis B and C?


Liver cancer patients with hepatitis B at a large U.S. cancer center appeared to have worse disease status than those with hepatitis C, including larger tumors and more extensive liver involvement, according to research presented at the American Society of Clinical Oncology (ASCO) annual meeting this month in Chicago. Prognosis for the 2 groups was similar, however.

Over years or decades chronic hepatitis B virus (HBV) or hepatitis C virus (HCV) infection can lead to serious liver disease including cirrhosis and hepatocellular carcinoma (HCC), a type of primary liver cancer. HCC is a major cause of cancer death worldwide, and hepatitis B and C are leading risk factors. But it is not well understood how liver cancer outcomes differ for people with HBV (a DNA virus in the Hepadnavirus family that integrates its genetic material into host cells) versus HCV (an RNA virus in the Flavivirus family).

Marc Isamu Uemura from the University of Texas and colleagues evaluated pathological and clinical characteristics of 815 patients with hepatocellular carcinoma referred for treatment at MD Anderson Cancer Center between 1992 and 2011. A total of 343 had hepatitis B and 472 had hepatitis C. Three-quarters were men and a majority were Texas residents.


  • Patients with HBV developed HCC at a younger age, on average, than those with HCV (57.4 vs 61.3 years, respectively).
  • Hepatitis B patients were more likely than hepatitis C patients to have:

o   Poorly differentiated tumors: 27% vs 19%, respectively;

o   Portal thrombosis: 36% vs 30%;

o   Tumor size >5 cm: 49% vs 35%;

o   Extensive liver involvement (>50%): 43% vs 27%;

o   Advanced CLIP stage (3-6): 44% vs 37%;

o   Higher levels of alpha-fetoprotein (AFP), a diagnostic biomarker for liver cancer.

  • However, people with hepatitis C were more likely than those with hepatitis B to have cirrhosis (86% vs 60%, respectively), as well as other risk factors associated with advanced liver disease including smoking (73% vs 56%), alcohol use (70% vs 49%), and diabetes (24% vs 18%).
  • 1-year survival rates were similar in both groups, at 43%.
  • Median survival was a bit longer for people with hepatitis B (9.3 months) compared with hepatitis C (10.9 months).

"Significant clinico-pathologic variations exist in HCC patients associated with HCV vs HBV, which may impact patients’ eligibility for treatment, but not prognosis," the researchers concluded.



MI Uemura, AO Kaseb, R Abdel-Wahab, et al. 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? 2015 American Society of Clinical Oncology (ASCO) Annual Meeting. Chicago, May29-June 2, 2015. Abstract 4011.