National Cohort of Uncomplicated Alcoholic Cirrhosis (CIRRAL)
CIRRAL: Hepatocellular Carcinoma in Patients With Uncomplicated Alcoholic Cirrhosis: Incidence and Predictive Factors. A Multicentric Prospective Cohort
調査の概要
状態
条件
詳細な説明
Patients will be selected for the study if they met all the inclusion criteria, without any of the non-inclusion criteria, ie compensated Child Pugh A alcoholic cirrhosis without viral chronic hepatitis B or C, and without any detectable HCC. They will be offered, during a consultation as part of their usual care, to participate in the study. An information note will be issued. Patients agreeing to participate should date and sign informed consent. Usual biological tests and liver ultrasonography will be performed if not done within 90 days prior to inclusion. During this visit, 20 ml of blood will be collected for freezing and storage of serum and plasma, and constitution of a DNA library.
From the reviews conducted at baseline, patients with at least one exclusion criteria (ie decompensation of cirrhosis, Child Pugh score ≥ 7, co-infection with HBV or HCV, or liver focal lesion suggestive of HCC will be excluded (and their serum samples achieved for the BioBank will be destroyed):
Monitoring: According to current guidelines, patients will have periodical surveillance with liver ultrasonography and medical consultation at least every 6 months, blood tests at least every year, periodic assessment of esophageal and gastric varices (every 1 to 3 years) and prevention of their rupture if any. An additional blood sampling of 20 ml will be taken at baseline and every year in order to perform serum, plasma, and DNA libraries; Data will be standardized and centralized in a single database.
Statistical Analysis: Methods for censored data with competitive risks. Number of subjects to include: The planned number is 1200 subjects included in 3 years. Assuming a minimal annual incidence of HCC about 2% in patients with alcoholic cirrhosis, and a proportion of lost to follow-up of around 20% in this poorly compliant population, a sample of 3000 patients could demonstrate the existence of predictive factors for the occurrence of HCC associated with a relative risk at least equal to 2, with a power of 90%. However, the enrollment of 3000 patients recruited in three years is not a realistic goal. For practical reasons and since the data currently available are very limited regarding the precise incidence of HCC and the strength of association between risk factors and HCC in patients with alcoholic cirrhosis, the minimum number of patients included in the cohort CIRRAL was set at 1200. Regarding an expected percentage of patients lost to follow close to 20%, the final number of patients with sufficient follow-up will be 1000.
Expected results
- description of the incidence of HCC occurrence in patients with alcoholic cirrhosis;
- identification of predictive factors for the occurrence of HCC c) identification of prognostic factors for survival. In addition, nested scientific projects will use the database and collected samples of this prospective cohort, thus constituting significant savings of resources. However, these nested scientific projects should include a specific need of organization and financing clean, and may involve only a fraction of the population included. The areas involved are very varied (immunology, genetics, imaging, evaluation of fibrosis, biostatistics, , quality of life, economy, etc.).
研究の種類
入学 (実際)
連絡先と場所
研究場所
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Bondy、フランス、93140
- Jean Verdier hospital (AP-HP)
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参加基準
適格基準
就学可能な年齢
健康ボランティアの受け入れ
受講資格のある性別
サンプリング方法
調査対象母集団
説明
Inclusion Criteria:
- age ≥ 18 years
- histologically proven cirrhosis
- no previous HCC (treated or not )
- excessive consumption of alcohol, considered as the main cause of cirrhosis
- signed informed consent.
Exclusion Criteria:
- serious associated short-term life threatening disease (except associated HIV viral infection and the liver disease itself),
- decompensation of cirrhosis (bleeding or ascites),
- co-infection with HBV or HCV;
- liver focal lesion suggestive of HCC
- Child Pugh score ≥ 7 (Class B or C).
- patient under guardianship
- pregnant women
- inability to regular monitoring, for whatever reason
研究計画
研究はどのように設計されていますか?
デザインの詳細
- 観測モデル:コホート
- 時間の展望:見込みのある
この研究は何を測定していますか?
主要な結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
---|---|---|
HCC Occurrence
時間枠:3 years
|
cumulative incidence within 3 years
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3 years
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二次結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
---|---|---|
Mortality
時間枠:3 years
|
overall mortality - whatever the cause of death
|
3 years
|
Liver-related mortality
時間枠:3 years
|
cumulative incidence of liver-related deaths
|
3 years
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Alcohol- and cirrhosis-related event free survival
時間枠:3 years
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event free survival where events are ascitis, digestive hemorrhage, icterus, encephalopathy, non-liver events related to alcohol, bacterial infection and death free of those events
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3 years
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協力者と研究者
協力者
捜査官
- 主任研究者:Nathalie GANNE, MD PhD、Assistance Publique - Hôpitaux de Paris
出版物と役立つリンク
研究記録日
主要日程の研究
研究開始
一次修了 (実際)
研究の完了 (予想される)
試験登録日
最初に提出
QC基準を満たした最初の提出物
最初の投稿 (見積もり)
学習記録の更新
投稿された最後の更新 (実際)
QC基準を満たした最後の更新が送信されました
最終確認日
詳しくは
本研究に関する用語
追加の関連 MeSH 用語
その他の研究ID番号
- NI09020
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