Colchicine
Delays the Development of Hepatocellular Carcinoma in Patients with Chronic Viral
Hepatitis
Hepatocellular
carcinoma (HCC) is a form of liver cancer associated with cirrhosis.
With an annual incidence of 3% to 9%, it is one of the major causes of death in
cirrhotic patients. Viral hepatitis (e.g., hepatitis
B or C) is associated with an increased
risk of HCC, possibly due to an inflammatory reaction.  Colchicine
is an anti-inflammatory agent that inhibits the formation of intracellular microtubules,
affecting mitosis (cell division) and fibrogenesis (production of fibrous tissue).
Clinical studies have failed to demonstrate that colchicine slows the progression
of fibrosis in patients with liver cirrhosis, but it has not been evaluated for
the prevention of HCC.
As
described in the September 11, 2006 issue of Gut, 186 patients with liver
cirrhosis related to viral hepatitis were evaluated in a retrospective cohort
study; 116 received treatment with colchicine. The minimum follow-up time was
3 years (median 84 months). Baseline characteristics of treated and untreated
patients were similar. Results 
The percentage of patients who developed HCC was significantly lower in the colchicine
group compared with the untreated group (9% vs. 29%; P = 0.001).
By multivariate analysis, the following factors were associated with the earlier
development of HCC:
- alpha-fetoprotein level of 5 ng/dL or higher (P =
0.03);
- platelet counts below 100,000 at diagnosis (P = 0.05);
- alanine
aminotransferase (ALT) levels of 52 IU or higher (P = 0.006);
- lack of treatment
with colchicine (P = 0.0001).
The average time to development of HCC was 222 months in the patients who received
colchicine versus 150 months in the untreated patients.
Conclusion "The
results suggest that treatment with colchicine prevents and delays the development
of HCC in patients with hepatitis virus-related cirrhosis," the authors wrote.
"The protective mechanisms of colchicine over the development of HCC could
be related to anti-inflammatory properties and inhibition of mitosis. Prospective
studies to confirm this observation with a greater number of patients and long-term
follow-up may be indicated."
10/17/06
Reference
O
Arrieta, J L Rodriguez-Diaz, V Rosa-Camargo, and others. Colchicine delays the
development of hepatocellular carcinoma in patients with hepatitis virus-related
liver cirrhosis. Cancer 107(8): 1852-1858. September 11, 2006.
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