Prevalence and characteristics of hepatitis C virus-related hepatocellular carcinoma in a Spanish university hospital

1

Introduction

Liver cancer is the sixth most common cancer and the second leading cause of cancer-related mortality worldwide [1] . Hepatocellular carcinoma (HCC) arises in the setting of chronic liver diseases (CLD) and represents > 90% of liver cancers [2] . Liver cancer incidence rate varies between geographic regions, according to the prevalence of liver disease risk factors such as hepatitis C virus (HCV), hepatitis B virus (HBV), alcohol consumption, and metabolic-associated fatty liver disease (MAFLD) [34] . Importantly, modelling studies indicate that liver cancer incidence will continue increasing in the next years [56] . Despite MAFLD rise, HCV is still the most prevalent HCC etiology in Western Europe [23] . Based on recent epidemiologic studies, the attributable fraction of HCV-related HCC in Spain is 47–57% [78] .

HCV is a hepatotropic RNA virus related to diverse organic conditions and, specifically, to CLD and HCC [910] . HCV increases HCC 15–20-fold as compared to HCV-negative individuals [11] . However, little is known about the specific clinical characteristics and prognosis of HCV-related HCC as compared to other HCC etiologies. HCV-related HCC appears in a cirrhotic background in > 90% of cases, whereas HBV-related and MAFLD-related HCC can be detected in a non-cirrhotic liver [211] . Also, HCV-related HCC shows distinct molecular features [12] , which can impact its clinical phenotype. However, how these particularities translate into distinct patients’ characteristics or HCC prognosis remains underexplored. Therefore, this study aimed at: (1) comparing the clinical characteristics of HCV and non-HCV-related HCC patients at the time of HCC presentation; (2) assessing prognostic differences between HCV and non-HCV-related HCC, and (3) exploring the evolution of HCV-related HCC patients throughout the years.