ArticleJournal of internal medicine2023
Unrecognized liver cirrhosis is common and associated with worse survival in hepatocellular carcinoma: A nationwide cohort study of 3473 patients.
Article in Journal of internal medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed, 19 citations in OpenAlex.
- Socioeconomic Inequalities in Receipt of Curative-Intent Treatment and Survival After Surveillance-Detected Hepatocellular Carcinoma: A Nationwide Cohort Study.Alimentary pharmacology & therapeutics · 2026Article
- Disentangling the Effect of BMI on Hepatocellular Carcinoma From Cirrhosis With Multivariable Mendelian Randomization.Liver international : official journal of the International Association for the Study of the Liver · 2026Article
- Liver cancer risk stratification using deep learning on nationwide longitudinal health screening data: a retrospective cohort study.BMC medical informatics and decision making · 2026Article
- Rates and Factors Associated With Hepatocellular Carcinoma Diagnosis, Stage, Treatment, and Survival.Gastro hep advances · 2026Article
- Socioeconomic inequalities in diagnostics, care and survival outcomes for hepatocellular carcinoma in Sweden: a nationwide cohort study.The Lancet regional health. Europe · 2025Article
- ReevaluatingWorld journal of gastroenterology · 2025Article
- Health disparities in cirrhosis care and liver transplantation.Nature reviews. Gastroenterology & hepatology · 2025Review
- Epidemiology of liver cancer in Kazakhstan: data from the Unified National Electronic Health System, 2014-2023.PloS one · 2025Article
- Risk Score for Hepatocellular Cancer in Adults Without Viral Hepatitis or Cirrhosis.JAMA network open · 2024Article
- Unrecognized liver cirrhosis is common and associated with worse survival in hepatocellular carcinoma: A nationwide cohort study of 3473 patients.Journal of internal medicine · 2023Article
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Authors and funding
6 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundData on unrecognized liver cirrhosis in patients with hepatocellular carcinoma (HCC) are derived mainly from cohorts with a risk of selection bias.
objectivesIn a population-based cohort study we aimed to determine the proportion, characteristics, and prognosis of HCC in patients with unrecognized cirrhosis.
methodsUsing the Swedish quality register for liver cancer and other nationwide registers, we identified all adults with HCC in Sweden between 2012 and 2018 (n = 3,473).
resultsThe final study cohort comprised 2670 patients with established cirrhosis, of which 1033 (39%) had unrecognized cirrhosis at HCC diagnosis. These patients were more often male, older, and had larger tumors, multinodular cancer, portal vein thrombosis, and extrahepatic metastasis compared to patients with known cirrhosis with HCC and under surveillance (34%). Compared to surveilled patients, those with unrecognized cirrhosis had worse median survival (0.89 years, 95% confidence interval [CI] = 0.78-1.01 vs. 3.79 years, 95%CI = 3.19-4.39), and an adjusted hazard ratio of 2.36 (95%CI = 2.09-2.66). Patients with cirrhosis but not under surveillance (27%) and patients with unrecognized cirrhosis had similar characteristics, such as equal proportions diagnosed at late stage (79%).
conclusionsCirrhosis is often not recognized in patients with HCC. Unrecognized cirrhosis is associated with more advanced HCC at diagnosis and a worse prognosis. More efforts are needed to diagnose cirrhosis at an earlier stage.
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