HIGH MALIGNANCY OF HEPATOCELLULAR-CARCINOMA IN ALCOHOLIC PATIENTS WITH HEPATITIS-C VIRUS

Background. We investigated the relationships between alcohol consumpt ion, the degree of malignancy evaluated histologically, and tumor-free survival rates.Methods. In 80 male patients with the hepatitis C viru s and small hepatocellular carcinomas (diameter of main tumor, 3.0 cm or less), 38 patients had drunk 86 gm or more of ethanol pem day for a t least 10 years until the detection of hepatocellular carcinoma (grou p 1), whereas the remaining 42 patients were nondrinkers or occasional drinkers (group 2). Results. Differences in the results of liver func tion tests between the groups were not statistically significant. The operative methods used in the groups were comparable. The proportion, of well-differentiated hepatocellular carcinoma was lower in group 1 t han in group 2 (p < 0.001)2). The prevalances of extracapsular invasio n, portal tumor thrombi, and intrahepatic metastasis were higher in gr oup 1 than in group 2 (p = 0.0085, p = 0.0319, and p = 0.0428, respect ively). The tumor-free survival rate after operation was lower in grou p 1 than in group 2 (p = 0.041 by the log-rank test; p = 0.032 by the generalized Wilcoxon test). Conclusions. These findings indicate that in group 1, even though tumors were small, the carcinomas were advance d and the outcomes after surgery were poor, suggesting that alcohol af fects the grade of malignancy of this disease.