Researchers from Mexico have reported that colchicine reduces the risk of developing hepatocellular carcinoma in patients with viral hepatic cirrhosis. The details of this retrospective study were published in the October 14, 2006, issue of Cancer.

Hepatocellular cancer is one of the most common cancers in the world, especially in Asia. The major cause of hepatocellular carcinoma is viral hepatitis due to hepatitis B and C. There is some evidence that early treatment with antiviral agents, such as lamivudine and interferon, can prevent the replication of the hepatitis B virus and possibly decrease the incidence of hepatocellular cancer. There is also evidence that vaccination to hepatitis B would prevent most cases of hepatocellular cancer due to this virus.

Hepatitis C affects approximately 170 million individuals world wide. Following acute infection, the virus persists in many patients and a minority can develop chronic disease. Chronic hepatitis can progress slowly over many decades to chronic active hepatitis and cirrhosis, ultimately leading to end stage liver disease or hepatocellular carcinoma. Approximately 20% of patients who develop cirrhosis will get cancer. It takes approximately 20 years to develop cirrhosis and 25-30 years to develop cancer. It is rare to develop hepatocellular carcinoma without cirrhosis.

Researchers looked at outcomes of 116 patients treated with colchicines (1 mg/day for 5 days per week) with the outcomes of 70 similar patients with viral cirrhosis who did not receive colchicines. The mean time of treatment in the colchicine group was 62.5 months. These patients were followed for a median of 84 months. These authors reported that after 3 years of observation 9% of the colchicine group developed hepatocellular carcinoma compared to 29% in the control group. They also reported that on multivariate analysis lack of treatment with colchicine was a statistically significant risk factor for the development of hepatocellular carcinoma. They also reported that the average time to development of hepatocellular cancer was 222 months in the colchicine group and 150 months in the control group. These authors suggested that treatment with colchicine delayed and possibly prevented the development of hepatocellular cancer in patients with viral cirrhosis at high risk. Treatment with colchicine appeared to be well tolerated.

Comments:  These observations made in a retrospective study will probably lead to a randomized trial to confirm these findings.

Reference: Arrieta O, Rodriguez-Diaz JL, Rosas-Camargo VR, et al. Colchicine delays the development of hepatocellular carcinoma in patients with hepatitis virus-related liver cirrhosis. Cancer . 2006;107:1852-1858.

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