We analyzed data from a surveillance program of 450 patients, aged 40 to 75 years, with alcoholic cirrhosis of Child-Pugh class A or B; patients were enrolled at the liver unit of a tertiary center from September 1992 through March 2010. Data were collected on 20 demographic, clinical, and laboratory variables at the start of the study. Patients were examined every 3 to 6 months for 5 years to identify risk factors for HCC; incidence was determined from a median follow-up time of 42 months.
Over the follow-up period, 62 patients developed HCC (43 in the first 5 y of follow-up evaluation), with an annual incidence of 2.6 % . By using multivariate analysis, age 55 years and older (hazard ratio, 2.39; 95 % confidence interval, 1.27-4.51) and platelet counts less than 125 ¡Á 103/mm3 (hazard ratio, 3.29; 95 % confidence interval, 1.39-7.85) were associated independently with the development of HCC. These variables were used to define 3 risk groups. The annual incidence of HCC in the group without either of these factors was 0.3 % (n = 93), the annual incidence with 1 factor was 2.6 % (n = 228), and the annual incidence with both factors was 4.8 % (n = 129) (P < .0001).
The annual incidence of HCC among patients with alcoholic cirrhosis of Child-Pugh class A or B is around 2.5 % . Age and platelet count can be used to classify the patients in 3 different risk groups for HCC development within the next 5 years.