Is female sex a significant favorable prognostic factor in hepatocellular carcinoma?

Farinati, Fabio; Sérgio, A.; Giacomin, A.; Nolfo, Maria Anna Di; Poggio, P. Del; Benvegnù, Luisa; Rapaccini, Gianludovico; Zoli, Marco; Borzio, Franco; Giannini, Edoardo G.; Caturelli, Eugenio; Trevisani, Franco

doi:10.1097/meg.0b013e32831a86f8

Cited by 53 publications

(74 citation statements)

References 47 publications

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Section: Introductionsupporting

confidence: 93%

“…According to our data, concurrent hepatitis C virus diagnosis and patient sex, do not appear significantly influencing survival of HCC patients after LT, in agreement with some previous data 23,29 . On the contrary, female patients and some liver disease may provide better prognosis to patients with HCC, but this is possibly more because of higher compliance with surveillance than to real biological differences 28,29 . Moreover, some of others donor-, In randomized Brazilian reports, the piggy-back approach was related to higher rate of pulmonary infiltrates 38 , but not to bacterial translocation 39 or stimuli for the production of inflammatory molecules 40 , when compared to the conventional method.…”

Section: Introductionsupporting

confidence: 93%

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Non-cancerous prognostic factors of hepatocellular carcinoma after liver transplantation

Batista¹,

Miranda²,

Sabat³

et al. 2012

Acta Cir. Bras.

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PURPOSE:To explore non-cancerous factors that may be related with medium-term survival (24 months) after liver transplantation (LT) in this data from northeast Brazil. METHODS:A cross-sectional study was carried out in patients who underwent deceased-donor orthotopic LT because hepatocellular carcinoma (HCC) at the University of Pernambuco, Brazil. Non-cancerous factors (i.e.: donor-, receptor-, surgery-and center-related variables) were explored as prognostic factors of medium-term survival using univariate and multivariate approachs. RESULTS:Sixty-one patients were included for analysis. Their three, six, 12 and 24-month overall cumulative survivals were 88.5%, 80.3%, 73.8% and 65.6%, respectively. Our univariate analysis identified red blood cell transfusion (Exp[b]=1.26; p<0.01) and hepatovenous reconstruction technique (84.6% vs. 51.4%, p<0.01; respectively for piggyback and conventional approaches) as significantly related to post-LT survival. The multivariate analysis confirmed the hepato-venous reconstruction technique was an independent prognostic factor. CONCLUSION:The piggyback technique was related to improved medium-term survival of hepatocellular carcinoma patients after liver transplantation in this northeast Brazilian sample.Key words: Organ Transplantation. Liver Neoplasms. Carcinoma, Hepatocellular. Survival Analysis. Prognosis. RESUMO OBJETIVO:Explorar fatores prognósticos não oncológicos para a sobrevivência de médio prazo (24 meses) de portadores de carcinoma hepatocelular tratados com transplante hepático. MÉTODOS: Estudo de corte incluindo pacientes submetidos a transplante ortotópico de fígado (doador-cadáver) pelo Serviço deCirurgia Geral e Transplante Hepático da Universidade de Pernambuco, UPE. Exploraram-se variáveis relacionadas ao doador, receptor, procedimento cirúrgico e serviço transplantador, como potenciais fatores prognósticos para a sobrevivência de médio prazo dos transplantados, aplicando-se análise uni e multivariada. Non-cancerous prognostic factors of hepatocellular carcinoma after liver transplantationActa Cirúrgica Brasileira -Vol. 27 (6) 2012 -397 RESULTADOS: Sessenta e um pacientes foram incluídos para análise. A sobrevivência cumulativa de três, seis, 12 e 24 meses observada foi de 88,5%, 80,3%, 73,8% e 65,6%, respectivamente. Por análise univariada, identificou-se a transfusão de hemácias (Exp[b]=1,26; p<0,01) e técnica cirúrgica empregada (84,6% vs. 51,4%, p<0,01; respectivamente, piggyback vs. convencional) como estatisticamente relacionadas à sobrevivência dos pacientes estudados. Por análise multivariada, confirmou-se a técnica empregada como fator prognóstico independente. CONCLUSÃO:A técnica cirúrgica piggyback se relacionou a melhor sobrevivência de médio prazo de pacientes com carcinoma hepatocelular após transplante de fígado nesta casuística do nordeste Brasileiro.

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Section: Introductionsupporting

confidence: 93%

Section: Introductionsupporting

confidence: 93%

Non-cancerous prognostic factors of hepatocellular carcinoma after liver transplantation

Batista¹,

Miranda²,

Sabat³

et al. 2012

Acta Cir. Bras.

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“…This drawback was particularly evident in men and in patients without seromarkers of viral infection, amongst whom about 50% of HCCs were diagnosed outside surveillance. The relation between patient sex and prevalence of HCC detected by surveillance has been already reported [21] and can be tentatively attributed to a lower compliance to surveillance of men and, particularly, of alcohol abusers (who are more frequently males than females). However, other two factors may have contributed: first, compared to viral cases, the oncological risk in non viral patients is probably underestimated by physicians.…”

Section: Discussionmentioning

confidence: 67%

Changing aetiological factors of hepatocellular carcinoma and their potential impact on the effectiveness of surveillance

Stroffolini

Trevisani

Pinzello

et al. 2011

Digestive and Liver Disease

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a b s t r a c tBackground: The aetiological factors of hepatocellular carcinoma may vary over time. Aims: The study assessed the potential impact of the aetiological factors on the effectiveness of surveillance in real-world patients. Methods: Multicentre, cross-sectional study enrolling consecutive hepatocellular carcinoma cases during a six month period. Results: 1733 cases (1311 prevalent and 422 incident) were recruited (mean age 68.6 years; 46.1% cases over 70 years; 73.9% males; 95.3% with cirrhosis); 63.0% were hepatitis C virus positive and 23.7% were virus negative. Amongst incident HCCs, 34.5% were single ≤3 cm and 54.4% met the Milan criteria; 61.6% were diagnosed during surveillance; virus negative patients showed the lowest rate of surveillance (51.0%). Surveillance was an independent predictor of detecting single HCCs ≤2 cm (O.R. = 5.4; 95% C.I. = 2.4-12.4) or HCCs meeting the Milan criteria (O.R. = 3.1; 95% C.I. = 1.9-5.2). Compared with an earlier Italian survey, there was a higher proportion of elderly subjects (P < 0.01), Child-Pugh class A cases (P < 0.01), of virus-negative patients (P < 0.01) and with single tumours ≤3 cm (P < 0.01) and a lower prevalence of hepatitis C virus positive individuals (P < 0.01). Conclusion: HCC is characterised by a growing prevalence of elderly patients and cases unrelated to hepatitis virus infections. The application of surveillance must be implemented, particularly amongst non-viral patients.

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“…Women tend to have less aggressive liver tumors than men at initial diagnosis23 and also have a better survival than men after treatments45. Possible contributing factors for the gender disparity of HCC include gender-specific lifestyle and social environments, such as alcohol consumption, smoking and HBV or HCV infection.…”

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confidence: 99%

Males develop faster and more severe hepatocellular carcinoma than females in krasV12 transgenic zebrafish

Spitsbergen

et al. 2017

Sci Rep

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Hepatocellular carcinoma (HCC) is more prevalent in men than women, but the reason for this gender disparity is not well understood. To investigate whether zebrafish could be used to study the gender disparity of HCC, we compared the difference of liver tumorigenesis between female and male fish during early tumorigenesis and long-term tumor progression in our previously established inducible and reversible HCC model – the krasV12 transgenic zebrafish. We found that male fish developed HCC faster than females. The male tumors were more severe from the initiation stage, characteristic of higher proliferation, activation of WNT/β-catenin pathway and loss of cell adhesion. During long-term tumor progression, the male tumors developed into more advanced multi-nodular tumors, whereas the female tumors remain uniform and homogenous. Moreover, regression of male tumors required longer time. We further investigated the role of sex hormones in krasV12 transgenic fish. Estrogen treatment showed tumor suppressing effect during early tumorigenesis through inhibiting cell proliferation, whereas androgen accelerated tumor growth by promoting cell proliferation. Overall, our study presented the zebrafish as a useful animal model for study of gender disparity of HCC.

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Is female sex a significant favorable prognostic factor in hepatocellular carcinoma?

Abstract: HCC in females has better prognosis, but this is possibly more because of higher compliance with surveillance than to real biological differences.

Cited by 53 publications

References 47 publications

Non-cancerous prognostic factors of hepatocellular carcinoma after liver transplantation

Non-cancerous prognostic factors of hepatocellular carcinoma after liver transplantation

Changing aetiological factors of hepatocellular carcinoma and their potential impact on the effectiveness of surveillance

Males develop faster and more severe hepatocellular carcinoma than females in krasV12 transgenic zebrafish

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