[Long-term prognosis of liver cirrhosis]

In order to elucidate the long-term prognosis of liver cirrhosis, we analyzed a total of 795 consecutive patients with viral or alcoholic cirrhosis prospectively. During the observation period (median, 5.8 yr), hepatocellular carcinoma (HCC) developed in 221 patients. Cumulative appearance rates of HCC were 19.4%, 44.3%, and 58.2% at the end of the 5th, 10th, and 15th year, respectively. When classified by the state of hepatitis virus infection, the appearance rates of HCC in 180 patients with only hepatitis B surface antigen and in 349 patients with only anti-hepatitis C virus (anti-HCV) were 14.2% and 21.5% at the 5th year, 27.2% and 53.2% at the 10th year, and 27.2% and 75.2% at the 15th year, respectively. Cox proportional hazard model identified that alpha-fetoprotein (p = 0.00001), age (p = 0.00067), positive anti-HCV (p = 0.00135), total alcohol intake (p = 0.00455), and indocyanine green retention rate (p = 0.04491) were independently associated with the appearance rates of HCC. The survival rates of patients with cirrhosis were 84.1%, 57.0%, and 30.9% at the end of the fifth, tenth, and fifteenth year, respectively.