Treatment and outcomes of treating of hepatocellular carcinoma among Medicare recipients in the United States: A population-based study

El–Serag, Hashem B.; Siegel, Abby B.; Davila, Jessica A.; Shaib, Yasser H.; Cayton-Woody, Mikele; McBride, Russell; McGlynn, Katherine A.

doi:10.1016/j.jhep.2005.10.002

Cited by 214 publications

(171 citation statements)

References 12 publications

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“…El Serag et al have previously shown that 19.2% of patients with unfavorable tumor features received potentially curative therapy. 8 In this study, approximately y39.8% of patients who did not receive therapy were diagnosed with stage I or II HCC. Reasons for not receiving therapy could not be clearly elucidated in this population-based study.…”

Section: Discussionmentioning

confidence: 75%

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Underutilization of therapy for hepatocellular carcinoma in the medicare population

Shah

Smith

et al. 2010

Cancer

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BACKGROUND:The incidence of hepatocellular carcinoma (HCC) is increasing in the United States, and the care of these patients remains highly specialized and complex. Multiple treatment options are available for HCC but their use and effectiveness remain unknown. METHODS: Using Surveillance, Epidemiology, and End Results (SEER)-Medicare linked data, 8730 patients who were diagnosed with HCC between 1991 and 2005 were identified. Therapy included surgical resection (8.7%), liver transplantation (1.4%), ablation (3.6%), or transarterial chemoembolization (16%). Patients who received no or palliative-only treatment were grouped together (NoTx; 70.3%). Patient, disease, and tumor factors were examined as determinants of therapy. RESULTS: HCC is increasing in the Medicare population. The median age at diagnosis was 75.1 years and 73.6% of patients were coded as white, 17.2% as Asian, 8.3% as black, and 0.9% as other race. The rate of therapy increased over time, but only 29.7% of patients overall underwent therapy. In patients with early stage HCC, only 43.1% underwent therapy. In the NoTx group, 49.4% did not have cirrhosis, 36.0% had tumors that measured <5 cm, and 39.8% were diagnosed with stage I or II disease when variables were complete. The use of therapy for all HCC patients increased over time, correlating with a commensurate increase in median survival. In multivariate regression analysis, patients who received any modality of treatment achieved significant benefit compared with the NoTx group (odds ratio, 0.41; 95% confidence interval, 0.39-0.43). CONCLUSIONS: In the Medicare population, HCC patients who received therapy experienced a substantial survival advantage over their nonoperative peers (NoTx). Despite evidence that many patients had favorable biological characteristics, <30% of patients diagnosed with HCC received any treatment.

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Section: Discussionmentioning

confidence: 75%

“…7,8 Using population-based data, we examined whether these differences exist on a national level and whether this variation and underuse of treatment may contribute to the poor outcomes noted after a diagnosis of HCC.…”

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confidence: 99%

Underutilization of therapy for hepatocellular carcinoma in the medicare population

Shah

Smith

et al. 2010

Cancer

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“…Surgical resection remains the major treatment for hepatocellular carcinoma (HCC). However, only 8%-15% of patients meet the criteria for surgical resection [1][2][3] and the long-term results after resection are still unsatisfactory [4] . The liver is also the most frequent site of metastatic disease from extrahepatic primary tumors [5] .…”

Section: Introductionmentioning

confidence: 99%

Psychological intervention reduces postembolization pain during hepatic arterial chemoembolization therapy: A complementary approach to drug analgesia

Wang

Liu²,

Sun³

et al. 2008

WJG

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AIM:To assess whether psychological intervention reduces postembolization pain during hepatic arterial chemoembolization therapy. METHODS:Two hundred and sixty-two patients, who required hepatic arterial chemoembolization for hepatic malignancy and postembolization pain, were randomized into control group (n = 46, receiving medication) and intervention group (n = 216, receiving psychological intervention and medication in turn). The symptom checklist-90 (SCL-90) was used to scale the psychological symptoms of the patients before operation. Pain was scored with a 0 to 10 numeric rating scale (NRS-10) before and after analgesia as well as after psychological intervention (only in intervention group). RESULTS:All psychological symptomatic scores measured with SCL-90 in the intervention group were higher than the normal range in Chinese (P < 0.05). The somatization, phobia and anxiety symptomatic scores were associated with pain numerical rating score before analgesia (r = 0.141, 0.157 and 0.192, respectively,

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“…It is one of the most aggressive human malignancies and previous data have shown that the five-year survival rate is poor (5). The most effective therapy for HCC is usually surgical resection or liver transplantation; however, in ~70% of patients surgery is unsuitable due to tumor metastasis or liver cirrhosis (6).…”

Section: Introductionmentioning

confidence: 99%

Anticancer agent icaritin induces apoptosis through caspase-dependent pathways in human hepatocellular carcinoma cells

Sun

Peng

et al. 2014

Molecular Medicine Reports

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Abstract.Icaritin is an active ingredient derived from the plant Herba epimedium, which exhibits various pharmacological and biological activities. However, the function, and the underlying mechanisms of icaritin on the growth of SMMC-7721 human hepatoma cells have yet to be elucidated. The present study aimed to investigate the function and underlying mechanisms of icaritin in the growth of SMMC-7721 cells. The cells were treated with varying concentrations of icaritin for 12, 24 and 48 h, respectively, prior to cytotoxic analysis. Apoptosis of SMMC-7721 cells following treatment with icaritin was measured using flow cytometry. The gene expression of mitochondria-and Fas-mediated caspase-dependent pathways was detected by reverse transcription-quantitative polymerase chain reaction and western blotting. Statistical analysis was performed by Student's t-test and one-way analysis or variance. The present study demonstrated that treatment with icaritin significantly inhibited growth, and induced apoptosis of SMMC-7721 cells, in a time-and dose-dependent manner. In addition, icaritin triggered the mitochondrial/caspase apoptotic pathway, by decreasing the Bcl-2/Bax protein ratio and increasing activation of caspase-3. Icaritin also activated the Fas-mediated apoptosis pathway, as was evident by the increased expression levels of Fas and activation of caspase-8. These data suggest that icaritin may be a potent growth inhibitor and induce apoptosis of SMMC-7721 cells through the mitochondria-and Fas-mediated caspase-dependent pathways. The present study may provide experimental evidence for preclinical and clinical evaluations of icaritin for HCC therapy.

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Treatment and outcomes of treating of hepatocellular carcinoma among Medicare recipients in the United States: A population-based study

Cited by 214 publications

References 12 publications

Underutilization of therapy for hepatocellular carcinoma in the medicare population

Underutilization of therapy for hepatocellular carcinoma in the medicare population

Psychological intervention reduces postembolization pain during hepatic arterial chemoembolization therapy: A complementary approach to drug analgesia

Anticancer agent icaritin induces apoptosis through caspase-dependent pathways in human hepatocellular carcinoma cells

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