Hepatocellular Carcinoma-Related Mortality in the USA, 1999–2018

Ramani, Ananthakrishnan; Tapper, Elliot B.; Griffin, Connor; Shankar, Nagasri; Parikh, Neehar D.; Asrani, Sumeet K.

doi:10.1007/s10620-022-07433-8

Cited by 14 publications

(9 citation statements)

References 44 publications

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“…However, North America showed a significant uptrend in mortality, although the results of previous literature are conflicting. Ramani et al[ 50 - 52 ] noted a decline in the death rate from HCV-related HCC since 2011, attributing this to various factors: (1) The introduction of Direct-acting Antivirals (DAAs); (2) Enhanced screening and better access to HCC therapies; (3) Aging of the HCV-infected birth cohort alongside competing risks from other causes of death; and (4) Inherent differences in the remaining HCV patients from the birth cohort, leading to a reduced risk of developing HCV cirrhosis and HCC. However, Younossi et al [ 53 ] showed a statistically significant increase in in-hospital mortality for HCV admissions from 2005-2009.…”

Section: Discussionmentioning

confidence: 99%

Global trends in hepatitis C-related hepatocellular carcinoma mortality: A public database analysis (1999-2019)

Ali,

Vikash,

Moond

et al. 2024

World J Virol

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BACKGROUND Hepatitis C is the leading cause of chronic liver disease worldwide and it significantly contributes to the burden of hepatocellular carcinoma (HCC). However, there are marked variations in the incidence and mortality rates of HCC across different geographical regions. With the advent of new widely available treatment modalities, such as direct-acting antivirals, it is becoming increasingly imperative to understand the temporal and geographical trends in HCC mortality associated with Hepatitis C. Furthermore, gender disparities in HCC mortality related to Hepatitis C are a crucial, yet underexplored aspect that adds to the disease's global impact. While some studies shed light on gender-specific trends, there is a lack of comprehensive data on global and regional mortality rates, particularly those highlighting gender disparities. This gap in knowledge hinders the development of targeted interventions and resource allocation strategies. AIM To understand the global and regional trends in Hepatitis C-related HCC mortality rates from 1990 to 2019, along with gender disparities. METHODS We utilized the Global Burden of Disease database, a comprehensive repository for global health metrics to age-standardized mortality rates due to Hepatitis C-related HCC from 1999 to 2019. Rates were evaluated per 100000 population and assessed by World Bank-defined regions. Temporal trends were determined using Joinpoint software and the Average Annual Percent Change (AAPC) method, and results were reported with 95% confidence intervals (CI). RESULTS From 1990 to 2019, overall, there was a significant decline in HCC-related mortality rates with an AAPC of -0.80% (95%CI: -0.83 to -0.77). Females demonstrated a marked decrease in mortality with an AAPC of -1.06% (95%CI: -1.09 to -1.03), whereas the male cohort had a lower AAPC of -0.52% (95%CI: -0.55 to -0.48). Regionally, East Asia and the Pacific demonstrated a significant decline with an AAPC of -2.05% (95%CI: -2.10 to -2.00), whereas Europe and Central Asia observed an uptrend with an AAPC of 0.72% (95%CI: 0.69 to 0.74). Latin America and the Caribbean also showed an uptrend with an AAPC of 0.06% (95%CI: 0.02 to 0.11). In the Middle East and North Africa, the AAPC was non-significant at 0.02% (95%CI: -0.09 to 0.12). North America, in contrast, displayed a significant upward trend with an AAPC of 2.63% (95%CI: 2.57 to 2.67). South Asia (AAPC -0.22%, 95%CI: -0.26 to -0.16) and Sub-Saharan Africa (AAPC -0.14%, 95%CI: -0.15 to -0.12) trends significantly declined over the study period. CONCLUSION Our study reports disparities in Hepatitis C-related HCC mortality between 1999 to 2019, both regionally and between genders. While East Asia and the Pacific regions showed a promising decline in mortality, North America has experienced a concerning rise in mortality. These regional variations highlight the need for healthcare policymakers and practitioners to tailor public health strategies and interventions. The data serves as a call to action, particularly for regions where mortality rates are not improving, emphasizing the necessity for a nuanced, region-specific approach to combat the global challenge of HCC secondary to Hepatitis C.

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Section: Discussionmentioning

confidence: 99%

Global trends in hepatitis C-related hepatocellular carcinoma mortality: A public database analysis (1999-2019)

Ali,

Vikash,

Moond

et al. 2024

World J Virol

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“…[9][10][11][12][13][14][15][16][17] Aging is a major global trend that has raised great concerns worldwide. With the increasing number of aging citizens, the age-adjusted HCC mortality rate has risen, [18][19][20] including in mainland China. 21 Though previous clinical trials related to uHCC did not limit the upper boundary of age, considering relatively complicated physical conditions in elderly patients, they might not be fully included in studies.…”

Section: Introductionmentioning

confidence: 99%

Efficacy and Safety of TKI Plus PD-1 Inhibitors in Elderly uHCC Patients: A Retrospective Study

Chen¹,

Jin²,

Zhao³

et al. 2022

JHC

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To explore the efficacy and safety of sorafenib-or lenvatinib-based combination therapy with PD-1 inhibitors in elderly patients aged ≥75 years with unresectable hepatocellular carcinoma (uHCC). Patients and Methods: Systemic therapy-naïve uHCC patients who received first-line sorafenib-or lenvatinib-based combination therapy with PD-1 inhibitors were continually reviewed. The primary endpoint was overall survival (OS), and the secondary endpoints were progression-free survival (PFS), objective response rate (ORR), and disease control rate (DCR) in accordance with the Response Evaluation Criteria in Solid Tumors version 1.1. Adverse events (AEs) and immune-related AEs (irAEs) were also evaluated. Groups and subgroups were separated at the ages of 65 and 75 years and compared with 1:1 matching. Results: Total 169 eligible patients were enrolled, including 24 aged ≥75 years. Median progression-free survival (PFS) and overall survival (OS) in these 24 elderly patients were 4.6 (95% CI: 2.6-6.6) months, and 17.0 (95% CI: 11.2-22.8) months, with 3-, 6-, 12month OS rate at 82.90%, 73.70%, and 57.50%. Age ≥75 years was confirmed to be a risk factor influencing PFS among patients aged ≥65 years. Adverse events (AEs) were recorded in all these 24 elderly patients, with seven patients experiencing immune-mediated AEs (irAEs). Nearly 30% of elderly patients stopped treatment due to AEs (16% of these due to irAEs). No statistical differences were found in all efficacy endpoints at the cutoff age of 65 years. Conclusion: For patients aged ≥75 years, application of PD-1 inhibitors in combination with sorafenib or lenvatinib is promising, but this has to be done with caution and needs to be confirmed by future prospective studies.

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“…Liver cancer is a global health problem, with an estimated increase of 32% by 2040 [ 1 ]. Representing 90% of liver cancers, hepatocellular carcinoma (HCC) causes 700,000 deaths annually.…”

Section: Introductionmentioning

confidence: 99%

Activated Hepatic Stellate Cells in Hepatocellular Carcinoma: Their Role as a Potential Target for Future Therapies

Ali

Trailin

Ambrożkiewicz

et al. 2022

IJMS

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Hepatocellular carcinoma (HCC) is a global healthcare challenge, which affects more than 815,000 new cases every year. Activated hepatic stellate cells (aHSCs) remain the principal cells that drive HCC onset and growth. aHSCs suppress the anti-tumor immune response through interaction with different immune cells. They also increase the deposition of the extracellular matrix proteins, challenging the reversion of fibrosis and increasing HCC growth and metastasis. Therapy for HCC was reported to activate HSCs, which could explain the low efficacy of current treatments. Conversely, recent studies aimed at the deactivation of HSCs show that they have been able to inhibit HCC growth. In this review article, we discuss the role of aHSCs in HCC pathophysiology and therapy. Finally, we provide suggestions for the experimental implementation of HSCs in HCC therapies.

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Hepatocellular Carcinoma-Related Mortality in the USA, 1999–2018

Cited by 14 publications

References 44 publications

Global trends in hepatitis C-related hepatocellular carcinoma mortality: A public database analysis (1999-2019)

Global trends in hepatitis C-related hepatocellular carcinoma mortality: A public database analysis (1999-2019)

Efficacy and Safety of TKI Plus PD-1 Inhibitors in Elderly uHCC Patients: A Retrospective Study

Activated Hepatic Stellate Cells in Hepatocellular Carcinoma: Their Role as a Potential Target for Future Therapies

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