Effect of Heavy Alcohol Intake on Long‐term Results after Curative Resection of Hepatitis C Virus‐related Hepatocellular Carcinoma

We studied the effect of heavy alcohol intake (ethanol intake ≥80 g/day for ≥5 yr) on long‐term results in 53 patients with hepatitis C virus (HCV)‐related hepatocellular carcinoma (HCC) who had undergone curative hepatic resection. Cell proliferative activity in the tumor and non‐tumorous liver was also assessed by counting argyrophilic nucleolar organizer region‐associated proteins (Ag‐NOR) in the resected specimens. Twenty patients (20 males, 0 females) were positive for heavy alcohol intake [AI(+)] and 33 (28 males, 5 females) were not [AI(‐)]. All patients were positive for HCV antibody and negative for hepatitis B surface antigen. Carcinoma recurred within 3 to 51 postoperative months in 42 (79.2%) of the 53 patients. The median disease‐free survival time was 12.6 mo in the AI(+) group and 25.4 mo in the AI(‐) group (P<0.01). The AI(+) group also had significantly poorer survival than the AI(‐) group (P<0.05, 3‐year survival rate: 66.7% vs. 93.5%). HCC tumor in the AI(+) group showed significantly increased proliferative activity compared with that in the AI(‐) group (P<0.05, Ag‐NOR number: 2.3±0.8 vs. 1.9±0.4). However, there was no significant difference between the numbers of Ag‐NORs in non‐tumorous liver from these two groups (1.5±0.2 vs. 1.5±0.2). Patients with heavy alcohol intake should be followed particularly closely, even if they have received curative surgery, since heavy alcohol intake is closely related to a poor postoperative prognosis.