Epidemiology, clinical-treatment patterns and outcome in 256 hepatocellular carcinoma cases

Fenoglio, Luigi; Serraino, Cristina; Castagna, Elisabetta; Cardellicchio, Adele; Pomero, Fulvio; Grosso, Maurizio; Senore, Carlo

doi:10.3748/wjg.v19.i21.3207

Cited by 17 publications

(25 citation statements)

References 37 publications

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“…The peak age of incidence of HCC was found to be in older population with mean age 65 years, which is in line with the recently published data from Saudi Arabia [ 22 ] and countries like Italy [ 29 ], Japan [ 30 ], and Portugal [ 31 ]. However, this is fairly different from the average age as reported in the latest US literature, which was between 57 and 59 years [ 32 – 34 ].…”

Section: Discussionsupporting

confidence: 88%

Clinical Presentation, Risk Factors, and Treatment Modalities of Hepatocellular Carcinoma: A Single Tertiary Care Center Experience

Aljumah

Kuriry

AlZunaitan

et al. 2016

Gastroenterology Research and Practice

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Objective. To investigate the risk factors, clinical characteristics, treatment modalities, and outcomes in Saudi patients with HCC and propose points for early detection of the disease. Methods. Patients were stratified according to underlying risk factors for the development of HCC. Barcelona Clinic Liver Cancer (BCLC) was used for cancer staging. Treatment was classified into surgical resection/liver transplantation; locoregional ablation therapy; transarterial embolization; systemic chemotherapy; and best supportive care. Results. A total of 235 patients were included. Males had higher tumor size and incidence of portal vein thrombosis. Viral hepatitis was a risk factor in 75.7%. The most common BCLC stages were B (34.5%) and A (33.6%), and the most common radiological presentation was a single nodule of less than 5 cm. Metastases were present in 13.2%. Overall, 77 patients (32.8%) underwent a potentially curative treatment as the initial therapy. The most commonly utilized treatment modality was chemoembolization with 113 sessions in 71 patients. The overall median survival was 15.97 ± 27.18 months. Conclusion. HCC in Saudi Arabia is associated with high prevalence of HCV. Potentially curative therapies were underutilized in our patients. Cancer stage BCLC-B was the most frequent (34.5%) followed by BCLC-A (33.6%). The overall median survival was shorter than other studies.

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Section: Discussionsupporting

confidence: 88%

Clinical Presentation, Risk Factors, and Treatment Modalities of Hepatocellular Carcinoma: A Single Tertiary Care Center Experience

Aljumah

Kuriry

AlZunaitan

et al. 2016

Gastroenterology Research and Practice

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“… 1 Because of early angioinvasion and metastasis, only a small proportion of patients with hepatocellular carcinoma (HCC) receives surgical resection or liver transplantation as a curative treatment. 2 Except for sorafenib, a multikinase inhibitor, there are no effective systemic treatments of HCC. Two large phase III randomized controlled trials showed that the median overall survival was 10.7 months 3 and 6.5 months 4 in a sorafenib-treated group.…”

Section: Introductionmentioning

confidence: 99%

Combined treatment with silibinin and either sorafenib or gefitinib enhances their growth-inhibiting effects in hepatocellular carcinoma cells

Gu¹,

Park²,

Choi³

et al. 2015

Clin Mol Hepatol

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Background/AimsSilibinin, the main component of silymarin, is used as a hepatoprotectant and exhibits anticancer effects against various cancer cells. This study evaluated the effects of a combination of silibinin with either gefitinib or sorafenib on hepatocellular carcinoma (HCC) cells.MethodsSeveral different human HCC cell lines were used to test the growth-inhibiting effects and cell toxicity of silibinin both alone and in combination with either gefitinib or sorafenib. The cell viability and growth inhibition were assessed using the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay, trypan blue staining, and a colony-forming assay. Furthermore, changes in epidermal growth factor receptor (EGFR)-related signals were evaluated by Western blot analysis.ResultsGefitinib, sorafenib, and silibinin individually exhibited dose-dependent antiproliferative effects on HCC cells. Combined treatment with silibinin enhanced the gefitinib-induced growth-inhibiting effects in some HCC cell lines. The combination effect of gefitinib and silibinin was synergistic in the SNU761 cell line, but was only additive in the Huh-BAT cell line. The combination effect may be attributable to inhibition of EGFR-dependent Akt signaling. Enhanced growth-inhibiting effects were also observed in HCC cells treated with a combination of sorafenib and silibinin.ConclusionsCombined treatment with silibinin enhanced the growth-inhibiting effects of both gefitinib and sorafenib. Therefore, the combination of silibinin with either sorafenib or gefitinib could be a useful treatment approach for HCC in the future.

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“…HCV accounts for over one-third of the cases of HCC in the USA (Davila) and around 90% of these patients have underlying cirrhosis or advanced fibrosis [20]. Over the past decade, the number of HCC cases related to NASH has been increasing [21]. In multivariate analysis, the investigators have identified four factors predictive for development of HCC; those include age, male gender, albumin and low platelet count.…”

Section: Discussionmentioning

confidence: 99%

Laboratory Predictors of Risk for Developing Hepatocellular Carcinoma in Cirrhosis

Bleibel¹,

Saleem²,

Saad³

et al. 2018

JGPLD

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Introduction: Hepatocellular carcinoma (HCC) is a significant cause of mortality and morbidity in patients with cirrhosis. Using laboratory tests to identify patients at high risk for developing HCC may improve outcome and reduce the cost of screening in this patient population. Methods: In this retrospective study, we included all adult patients evaluated for liver transplantation between 1993 and 2012 at a single university-based transplant center. We used the hospital database and electronic medical records to obtain patients' demographics and laboratory data. ICD-9 code was used to determine patients who developed HCC. Results: A total of 3284 Patients were included in the study. Patients were predominantly white (86%), male (56%), with mixed etiology of cirrhosis (26% viral, 17% EtOH, 52% other), had a mean age of 54 years (SD 11.4), MELD of 10 (SD 5.1), albumin 3.7 (SD 0.7), creatinine 1.0 (SD 0.7), INR 1.3 (SD 0.3),bilirubin 1.9 (SD2.8) and platelet count of 149,000 (SD 94,000). After a follow up of 2.7 years (SD 2.7), 5% developed HCC, 24% died, and 10% underwent liver transplantation. In univariate analyses, the following parameters were predictive of HCC risk: age (HR 1.018, 95% CI 1.004-1.032, p 0.01), male gender (HR 3.268, 95% CI 2.265-4.715, p <0.0001), INR (HR1.896, 95% CI 1.418-2.534, p <0.0001), albumin (HR 0.453, 95% CI 0.367-0.561, p <0.001), platelet count (HR 0.991, 95% CI 0.989-0.994, p <0.0001), bilirubin (HR 1.062, 95% CI 1.010-1.117, p 0.02) and MELD (HR 1.060, 95% CI 1.030-1.091, p <0.0001). Creatinine was not predictive. In multivariate analysis, only age, male gender, platelet count, and albumin were predictive of HCC. Patients with platelet count <100,000 and albumin <3 had the highest annual actuarial risk for HCC of 6.2%. Conclusion: older males with low platelet count and albumin level are at higher risk for developing HCC. The interval of HCC screening for males with platelet count <100,000 and albumin < 3 g/dl may need to be shortened. Further prospective studies are warranted to determine the optimal screening interval.

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Epidemiology, clinical-treatment patterns and outcome in 256 hepatocellular carcinoma cases

Abstract: This study showed that, between 2000-2005 and 2005-2010, the number of HCV-related HCC decreased, non-viral/non alcoholic etiologies increased and of surveillance programs were more frequently applied.

Cited by 17 publications

References 37 publications

Clinical Presentation, Risk Factors, and Treatment Modalities of Hepatocellular Carcinoma: A Single Tertiary Care Center Experience

Clinical Presentation, Risk Factors, and Treatment Modalities of Hepatocellular Carcinoma: A Single Tertiary Care Center Experience

Combined treatment with silibinin and either sorafenib or gefitinib enhances their growth-inhibiting effects in hepatocellular carcinoma cells

Laboratory Predictors of Risk for Developing Hepatocellular Carcinoma in Cirrhosis

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