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

Manon Allaire; Pierre Nahon; Richard Layese; Valérie Bourcier; Carole Cagnot; Patrick Marcellin; Dominique Guyader; Stanislas Pol; Dominique Larrey; Victor de Ledinghen; Denis Ouzan; Fabien Zoulim; Dominique Roulot; Albert Tran; Jean-Pierre Bronowicki; Jean-Pierre Zarski; Ghassan Riachi; P. Calès; Jean-Marie Péron; Laurent Alric; Marc Bourlière; Philippe Mathurin; Jean-Frédéric Blanc; Armand Abergel; Lawrence Serfaty; Ariane Mallat; Jean-Didier Grangé; Pierre Attali; Yannick Bacq; Claire Wartelle; Thong Dao; Dominique Thabut; Christophe Pilette; Christine Silvain; Christos Christidis; Eric Nguyen-Khac; Brigitte Bernard-Chabert; David Zucman; Vincent Di Martino; Angela Sutton; Eric Letouzé; Etienne Audureau; Françoise Roudot-Thoraval

doi:10.1002/hep.30034

Article dans une revue

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

Manon Allaire ^{1, 2, *} Pierre Nahon ³ Richard Layese ⁴ Valérie Bourcier ⁵ Carole Cagnot ⁶ Patrick Marcellin ⁷ Dominique Guyader ⁸ Stanislas Pol ^{9, 10, 11} Dominique Larrey ^{12, 13} Victor de Ledinghen ¹⁴ Denis Ouzan ¹⁵ Fabien Zoulim ¹⁶ Dominique Roulot ¹⁷ Albert Tran ¹⁸ Jean-Pierre Bronowicki ¹⁹ Jean-Pierre Zarski ^{20, 21} Ghassan Riachi ²² P. Calès ²³ Jean-Marie Péron ^{24, 25} Laurent Alric ²⁶ Marc Bourlière ²⁷ Philippe Mathurin ²⁸ Jean-Frédéric Blanc ^{29, 30} Armand Abergel ^{31, 32, 33, 34, 35} Lawrence Serfaty ³⁶ Ariane Mallat ^{37, 38, 39} Jean-Didier Grangé ⁴⁰ Pierre Attali ⁴¹ Yannick Bacq ⁴² Claire Wartelle Thong Dao ¹ Dominique Thabut ⁴³ Christophe Pilette Christine Silvain ⁴⁴ Christos Christidis ⁴⁵ Eric Nguyen-Khac ⁴⁶ Brigitte Bernard-Chabert ⁴⁷ David Zucman ⁴⁸ Vincent Di Martino ⁴⁹ Angela Sutton ⁵ Eric Letouzé ³ Etienne Audureau ^{50, 4} Françoise Roudot-Thoraval ⁵⁰

* Auteur correspondant

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 Physiopathologie du système immunitaire

10 Département d'hépatologie [CHU Cochin]

11 UPD5 - Université Paris Descartes - Paris 5

12 CHU Saint-Eloi

13 Cellules Souches, Plasticité Cellulaire, Médecine Régénératrice et Immunothérapies (IRMB)

14 Hôpital Haut-Lévêque - Centre d'investigation de la fibrose hépatique [CHU de 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 Hôpital Purpan [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

29 Physiopathologie du cancer du foie

30 Hôpital Haut-Lévêque [CHU Bordeaux]

31 IP - Institut Pascal

32 UCA [2017-2020] - Université Clermont Auvergne [2017-2020]

33 CNRS - Centre National de la Recherche Scientifique

34 SIGMA Clermont

35 Hépatologie Gastro-Entérologie

36 Service d'hépatologie [Saint-Antoine]

37 IMRB - Institut Mondor de Recherche Biomédicale

38 UMR INSERM U955

39 UPEC UP12 - Université Paris-Est Créteil Val-de-Marne - Paris 12

40 CHU Tenon [APHP]

41 Onxeo S.A.

42 Département d'hépato-gastro-entérologie [Hôpital Trousseau : CHRU Tours]

43 Service d'Hépato-Gastroentérologie [CHU Pitié-Salpêtrière]

44 CHU Poitiers - Centre hospitalier universitaire de Poitiers

45 Hellenic Open University [Patras]

46 Service d'Hépato-gastroentérologie [CHU Amiens-Picardie]

47 CHU Reims - Centre Hospitalier Universitaire de Reims

48 SMI - Service de Médecine Interne [Hôpital Foch, Suresnes]

49 Service d'Hépatologie, Hôpital Jean Minjoz, Centre Hospitalier Universitaire de Besançon, Université de Franche Comté

50 Service de santé publique [Mondor]

Abstract : 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).

Keywords : Adult Aged Antiviral Agents / therapeutic use Carcinom Hepatocellular / epidemiology Hepatocellular / pathology Carcinoma Hepatocellular / virology Cohort Studies Databases Factual Disease Progression Female France Hepatitis B Chronic / complications Chronic / drug therapy Chronic / pathology Hepatitis C Humans Liver Cirrhosis / epidemiology Liver Cirrhosis / physiopathology Liver Cirrhosis / virology Liver Neoplasms / epidemiology Liver Neoplasms / pathology Liver Neoplasms / virology Male Middle Aged Neoplasms / mortality Neoplasms / pathology Neoplasms / virology Prognosis Prospective Studies Risk Assessment Survival Analysis

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Article dans une revue

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Sciences du Vivant [q-bio]

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https://hal.univ-angers.fr/hal-02648452
Contributeur : Okina Université d'Angers <>
Soumis le : vendredi 29 mai 2020 - 09:36:09
Dernière modification le : vendredi 11 juin 2021 - 16:02:02

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

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