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Article Dans Une Revue Hepatology Année : 2018

Extrahepatic cancers are the leading cause of death in patients achieving hepatitis B virus control or hepatitis C virus eradication

1 Service d'Hépato-Gastro-Enterologie et Nutrition [CHU Caen]
2 CRI (UMR_S_1149 / ERL_8252 / U1149) - Centre de recherche sur l'Inflammation
3 U1162 - Génomique Fonctionnelle des Tumeurs Solides
4 CEpiA - Clinical Epidemiology and Ageing : Geriatrie Soins Primaires et Santé Publique
5 Hôpital Jean Verdier [AP-HP]
6 ANRS France Recherche Nord & sud Sida-hiv hépatites
7 Service d’Hépatologie [Hôpital Beaujon]
8 NuMeCan - Nutrition, Métabolismes et Cancer
9 Inserm U1223 - Physiopathologie du système immunitaire
10 Département d'hépatologie [CHU Cochin]
11 UPD5 - Université Paris Descartes - Paris 5
12 CHRU Montpellier - Hôpital Saint Eloi
13 Cellules Souches, Plasticité Cellulaire, Médecine Régénératrice et Immunothérapies (IRMB)
14 Hôpital Haut-Lévêque [CHU Bordeaux]
15 Institut Arnault Tzanck
16 HCL - Hospices Civils de Lyon
17 Service de Gastro-entérologie [Avicenne]
18 C3M - Centre méditerranéen de médecine moléculaire
19 Service d'Hépato-gastro-entérologie [CHRU Nancy]
20 Département d'hépato-gastroentérologie
21 INSERM U823 - Institut d'oncologie/développement Albert Bonniot de Grenoble
22 Service d'Hépato-Gastroentérologie [CHU Rouen]
23 HIFIH - Hémodynamique, Interaction Fibrose et Invasivité tumorales Hépatiques
24 CHU Toulouse - Centre Hospitalier Universitaire de Toulouse
25 UT3 - Université Toulouse III - Paul Sabatier
26 PHARMA-DEV - Pharmacochimie et Biologie pour le Développement
27 Service d'hépatologie et de gastroentérologie [Hôpital Saint-Joseph - Marseille]
28 Hôpital Claude Huriez [Lille]
29 LIRIC - Lille Inflammation Research International Center - U 995
30 Physiopathologie du cancer du foie
31 IP - Institut Pascal
32 UCA [2017-2020] - Université Clermont Auvergne [2017-2020]
33 CNRS - Centre National de la Recherche Scientifique
34 CHU Saint-Antoine [AP-HP]
35 IMRB - Institut Mondor de Recherche Biomédicale
36 UPEC UP12 - Université Paris-Est Créteil Val-de-Marne - Paris 12
37 Inserm U955 - Molecular virology and immunology – Physiopathology and therapeutic of chronic viral hepatitis (Team 18)
38 CHU Tenon [AP-HP]
39 Onxeo S.A.
40 Département d'Hépato-Gastroentérologie [Hôpital Trousseau, Tours]
41 CHIAP - Centre Hospitalier d'Aix en Provence [Aix-en-Provence]
42 CHU Pitié-Salpêtrière [AP-HP]
43 Centre Hospitalier Le Mans (CH Le Mans)
44 CHU de Poitiers - Centre hospitalier universitaire de Poitiers = Poitiers University Hospital
45 Hellenic Open University [Patras]
46 Service d'Hépato Gastroenterologie [CHU Amiens-Picardie]
47 GRAP - Groupe de Recherche sur l'alcool et les pharmacodépendances - UMR INSERM_S 1247
48 Hôpital universitaire Robert Debré [Reims]
49 Hôpital Foch [Suresnes]
50 Service d'Hépatologie [CHRU Besançon]
51 Service de santé publique [Mondor]
Pierre Nahon
Denis Ouzan
Fabien Zoulim
Lawrence Serfaty
Pierre Attali
  • Fonction : Auteur
Christos Christidis
David Zucman
Eric Letouzé

Résumé

Data on extrahepatic cancers (EHCs) in compensated viral cirrhosis are limited. The objective of the prospective multicenter Agence Nationale de Recherche sur le SIDA et les Hépatites virales CO12 CirVir cohort was to assess the occurrence of all clinical events in patients with compensated viral cirrhosis, including all types of cancer. Patients with the following inclusion criteria were enrolled in 35 French centers: (1) biopsy-proven hepatitis B virus (HBV) or hepatitis C virus (HCV) cirrhosis, (2) Child-Pugh A, or (3) absence of previous liver complications including primary liver cancer (PLC). Patients were followed up prospectively every 6 months. The standardized mortality ratio (SMR) was calculated according to age and gender using 5-year periods. The impact of sustained viral response (SVR) in HCV patients and maintained viral suppression in HBV patients were assessed using time-dependent analysis. A total of 1,671 patients were enrolled between 2006 and 2012 (median age, 54.9 years; men, 67.3%; HCV, 1,323; HBV, 317; HCV-HBV, 31). Metabolic features and excessive alcohol and tobacco consumption were recorded in 15.2%, 36.4%, and 56.4% of cases, respectively. After a median follow-up of 59.7 months, 227 PLCs were diagnosed (5-year cumulative incidence [CumI] 13.4%) and 93 patients developed EHC (14 patients with lymphoid or related tissue cancer and 79 with solid tissue cancer; 5-year EHC CumI, 5.9%). Compared to the general French population, patients were younger at cancer diagnosis, with significantly higher risk of EHC in HCV patients (SMR, 1.31; 95 confidence interval [CI], 1.04-1.64; P = 0.017) and after SVR (SMR = 1.57; 95% CI, 1.08-2.22; P = 0.013). EHC was the fourth leading cause of death in the whole cohort and the first in patients with viral control/eradication.

CONCLUSION: Compared to the general French population, HCV cirrhosis is associated with a higher risk of EHC and the first cause of death in patients with viral cirrhosis who achieve virological control/eradication. (Hepatology 2018).

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hal-02648452 , version 1 (14-02-2022)

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Paternité - Pas d'utilisation commerciale

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Manon Allaire, Pierre Nahon, Richard Layese, Valérie Bourcier, Carole Cagnot, et al.. Extrahepatic cancers are the leading cause of death in patients achieving hepatitis B virus control or hepatitis C virus eradication. Hepatology, 2018, 68 (4), pp.1245-1259. ⟨10.1002/hep.30034⟩. ⟨hal-02648452⟩
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