Differences in radiotherapy application according to regional disease characteristics of hepatocellular carcinoma

318 Background: Hepatocellular carcinoma (HCC) disproportionately affects minorities with higher age-adjusted incidence and mortality rates in Hispanics (H) and blacks (B) versus non-Hispanic whites (C). While H have the fastest rising rates of HCC of all ethnic groups per SEER analysis, little is known about race specific risk factors and disease characteristics. Methods: We retrospectively reviewed HCC patients (pts) treated at University of Illinois-Chicago between 1998 and 2005. Demographics, disease characteristics, treatment patterns, and survival were analyzed with descriptive statistics and chi-square p values. Results: Mean age of HCC pts (N=195) at diagnosis was 59.7 years + 9.8 (19.5% female; 22% aged 65 or older; 61.5% Medicare or Medicaid; 4.1% without insurance; 22.6% H; 31.2% B). Compared to C and B, H pts were more likely to have ascites and NASH and less likely to have ever smoked or have hepatitis C. Compared to B, H pts were more likely to have metabolic syndrome, diabetes, and encephalopathy (HE). Compared to C, B pts had lower MELD scores. Conclusions: In our patient population, Hispanic patients were significantly more likely to have diabetes and NASH, and lower frequency of tobacco use, HCV, and elevated AFP levels at diagnosis. [Table: see text]

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Hepatitis serology predicts tumor and liver-disease characteristics but not prognosis after resection of hepatocellular carcinoma

Journal of Gastrointestinal Surgery ◽

10.1016/j.gassur.2004.06.013 ◽

2004 ◽

Vol 8 (7) ◽

pp. 794-805 ◽

Cited By ~ 25

Author(s):

T PAWLIK ◽

R POON ◽

E ABDALLA ◽

J SARMIENTO ◽

I IKAI ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Liver Disease ◽

Disease Characteristics

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Regional disease characteristics and comorbidities of patients with schizophrenia in the Ziprasidone Observational Study of Cardiac Outcomes (ZODIAC): Findings from an international large simple trial

Open Journal of Psychiatry ◽

10.4236/ojpsych.2012.224059 ◽

2012 ◽

Vol 02 (04) ◽

pp. 423-432

Author(s):

John M. Kane ◽

Wolfgang Fleischhacker ◽

Francesca Kolitsopoulos ◽

Onur N. Karayal ◽

Jamie Geier ◽

...

Keyword(s):

Observational Study ◽

Disease Characteristics ◽

Cardiac Outcomes ◽

Regional Disease

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Comparative efficacy of treatment strategies for hepatocellular carcinoma: systematic review and network meta-analysis

BMJ Open ◽

10.1136/bmjopen-2017-021269 ◽

2018 ◽

Vol 8 (10) ◽

pp. e021269 ◽

Cited By ~ 15

Author(s):

Guo Tian ◽

Shigui Yang ◽

Jinqiu Yuan ◽

Diane Threapleton ◽

Qiyu Zhao ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Meta Analysis ◽

Treatment Strategies ◽

Indirect Evidence ◽

Percutaneous Ethanol Injection ◽

International Studies ◽

Ethanol Injection ◽

Disease Characteristics ◽

Transcatheter Arterial Chemoembolisation ◽

Treatment Comparisons

ObjectiveHepatocellular carcinoma (HCC) is the third leading cause of cancer death worldwide. We conducted network meta-regression within a Bayesian framework to compare and rank different treatment strategies for HCC through direct and indirect evidence from international studies.Methods and analysesWe pooled the OR for 1-year, 3-year and 5-year overall survival, based on lesions of size ˂ 3 cm, 3–5 cm and ≤5 cm, using five therapeutic options including resection (RES), radiofrequency ablation (RFA), microwave ablation (MWA), transcatheter arterial chemoembolisation (TACE) plus RFA (TR) and percutaneous ethanol injection (PEI).ResultsWe identified 74 studies, including 26 944 patients. After adjustment for study design, and in the full sample of studies, the treatments were ranked in order of greatest to least benefit as follows for 5 year survival: (1) RES, (2) TR, (3) RFA, (4) MWA and (5) PEI. The ranks were similar for 1- and 3-year survival, with RES and TR being the highest ranking treatments. In both smaller (<3 cm) and larger tumours (3–5 cm), RES and TR were also the two highest ranking treatments. There was little evidence of inconsistency between direct and indirect evidence.ConclusionThe comparison of different treatment strategies for HCC indicated that RES is associated with longer survival. However, many of the between-treatment comparisons were not statistically significant and, for now, selection of strategies for treatment will depend on patient and disease characteristics. Additionally, much of the evidence was provided by non-randomised studies and knowledge gaps still exist. More head-to-head comparisons between both RES and TR, or other approaches, will be necessary to confirm these findings.

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Clinical Presentation of Hepatocellular Carcinoma in African Americans vs. Caucasians: A Retrospective Analysis

Pathophysiology ◽

10.3390/pathophysiology28030026 ◽

2021 ◽

Vol 28 (3) ◽

pp. 387-399

Author(s):

Hrishikesh Samant ◽

Kapil Kohli ◽

Krunal Patel ◽

Runhua Shi ◽

Paul Jordan ◽

...

Keyword(s):

Risk Factors ◽

Hepatocellular Carcinoma ◽

Medical Center ◽

Academic Medical Center ◽

Ethnic Disparities ◽

Surveillance Program ◽

Chi Square ◽

Vein Thrombosis ◽

Disease Characteristics ◽

Academic Medical

Hepatocellular carcinoma (HCC) remains an important form of cancer-related morbidity and mortality in the U.S. and worldwide. Previous U.S.-based studies on survival suggest ethnic disparities in HCC patients, but the complex interplay of multiple factors that contribute are still incompletely understood. Here we considered the influences of risk factors contributing towards HCC survival, including ethnic background, over ten years at a premier academic medical center with a majority (57.20%) African American (AA) population. Retrospective HCC data were collected from 2008–2018 at LSUHSC-Shreveport, an urban tertiary medical center. Data included demographics, comorbidities, liver disease characteristics, and tumor parameters. Statistical analysis was performed using Chi Square and one-way ANOVA. Results: 229 HCC patients were identified (male 78.6%). The mean HCC age at diagnosis was 61 years (SD = 7.3). Compared to non-Hispanic Caucasians (42.7%), AA patients (57.2% of total) were older at presentation, had more frequent diabetes/dyslipidemia/NAFLD (45 (34.3%) compared with 19 (19.3%) in non-Hispanic Caucasians, p = 0.02), and had a larger HCC burden at diagnosis. We conclude that compared to white patients, despite having similar BMI and MELD scores and rates of portal vein thrombosis, AA patients with HCC in our cohort were older at presentation, had a significantly increased incidence of modifiable metabolic risk factors including diabetes, higher AFP values, increased incidence of gallstones, and larger sized HCCs, and were more likely to be outside Milan criteria. These findings have important prognostic and diagnostic implications for developing a more targeted HCC surveillance program.

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Surveillance of hepatocellular carcinoma in Slovakia

Gastroenterologie a hepatologie ◽

10.14735/amgh2020380 ◽

2020 ◽

Vol 74 (5) ◽

pp. 380-385

Author(s):

Světlana Adamcová Selčanová ◽

Ľubomír Skladaný ◽

Jana Čiefová ◽

Sylvia Dražilová ◽

Tomáš Koller ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Quality Control ◽

Hepatitis C Virus ◽

Liver Disease ◽

Hepatitis C ◽

Hbv Infection ◽

Disease Characteristics ◽

Quality Control Study ◽

Related Liver Disease ◽

Control Study

Background: Certain trials have demonstrated that surveillance of hepatocellular carcinoma (HCC) lowers mortality via earlier diagnosis and therapy. We aimed to analyse surveillance performance in order to define targets for improvement. Methods: We retrospectively analysed consecutive patients (pts) ELIGIBLE for surveillance between January 2001 and December 2010, with three questions: 1. How many have had surveillance RECOMMENDED and 2. PERFORMED, and by which method and 3. with what outcome. We divided the pts into three groups by diagnosis of cirrhosis or HBV infection (ELIGIBLE), written recommendation for surveillance (RECOMMENDED) and ≥ 2 US or alpha-fetoprotein (AFP) exams six months apart (PERFORMED). We recorded the demographics, liver disease characteristics, ultrasound (US), AFP, new lesions, their size and mortality. We excluded patients without data for analysis. Results: We identified 445 and excluded 52 of the ELIGIBLE pts. The remaining 393 pts formed the RECOMMENDED group: 334 (85%) with cirrhosis, 59 (15%) with HBV infection. The median age was 55 years, 34% were females. The most prevalent aetiologies were alcohol-related liver disease (ALD, 46%), non-alcoholic steatohepatitis (NASH, 17%) and hepatitis C virus (HCV, 12%). Surveillance was PERFORMED in 322 (82%) of the RECOMMENDED pts by US only in 1%, AFP in 40% and US with AFP in 31% of the pts, respectively. New lesions were detected in 2.2% of the pts, aged 63.5 years (53–79), with diameter of 31.5 mm (9–120) in 8 surveillance pts and 75 mm (35–115) in 2 pts without surveillance (p = 0.296). Conclusion: This quality control study has shown that the uptake of HCC surveillance in pts with valid indication was suboptimal, the methods used deviated considerably from the guidelines and the diameter of newly-detected lesions was larger than would be required for surveillance to be effective.

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