Alcohol consumption on liver function and its prognostic value in male patients with hepatocellular carcinoma: a retrospective cohort study

Background and Objective: Alcohol consumption has been proposed to be a main risk factor for hepatocellular carcinoma (HCC), especially in males. We aimed to investigate the effects of alcohol consumption on liver function in patients with HCC. We also explored the prognostic value of alcohol use in HCC. Methods: The medical records on 479 male HCC patients who underwent radical therapy between 2002 and 2012 were retrospectively reviewed. Kaplan-Meier curve, log-rank test, and Cox regression analysis were used to compare the overall survival (OS) and disease-free survival (DFS) between drinkers and non-drinkers. Results: A total of 138patients had a habit of alcohol use. Compared with non-drinkers, drinkerstended to have a high prevalence of cirrhosis (P = 0.004), an elevated levels of alanine aminotransferase (ALT) (P = 0.007) and gamma-glutamyltranspeptidase (GGT) (P < 0.001). A potential dose response relationship was also indicated between alcohol consumption and levels of liver enzymes. When stratified according to etiology, log-rank test identified drinking as a significant factor for predicting poor OS as well as DFS in non-hepatitis B non-hepatitis C (NBNC) related HCC (both P < 0.05) but not in hepatitis B or C virus induced HCC (both P > 0.05). In addition, alcohol consumption was more likely to affect survival in the subgroups of patients with younger age, presence of cirrhosis, higher level of AFP, larger tumor diameter, and single neoplasm. Multivariate analysis showed that drinking, tumor size, and TNM stage were the three independent predictors for OS and DFS in NBNC-related HCC patients. Conclusions: Alcohol consumption significantly elevated the levels of liver enzymes, increased the risk of cirrhosis, and reduced the survival time in male HCC patients, especially in those without infection of hepatitis virus.