Nikesh Hanumanthappa1, Byung Heon Cho2, Andrew McKay3, David Peretz3, Gerald Y Minuk4, Pascal Lambert5, Maged Nashed1. 1. Department of Radiation Oncology, CancerCare Manitoba, University of Manitoba, Winnipeg, Manitoba, Canada. 2. Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada. 3. Section of Hepatology, Department of Surgery, Health Sciences Centre, University of Manitoba, Winnipeg, Manitoba, Canada. 4. Section of Hepatology, Department of Internal Medicine, Health Sciences Centre, University of Manitoba, Winnipeg, Manitoba, Canada. 5. Department of Epidemiology and Statistics, CancerCare Manitoba, Winnipeg, Manitoba, Canada.
Abstract
Background: Hepatocellular carcinoma (HCC) has a very poor survival rate, especially for those who do not receive a potentially curative therapy. Methods: Treatment details were collected for 320 HCC patients diagnosed in Manitoba between January 2011 and December 2015. Patients had a mean age of 67.3 years, and 71.6% were men. Of these patients, 67 (20.9%) received curative treatment, 36 (11.3%) received non-curative treatment, and 217 (67.8%) received supportive care only; 71.3% of patients had liver cirrhosis. Alcoholic cirrhosis was the most common etiology of chronic liver disease (22.2%). Results: Those who received curative treatment had a significantly lower incidence of portal vein thrombosis and multinodular disease than those in other groups. Patients who received supportive care only had a higher incidence of ascites. We found no difference in the distribution of cirrhosis or portal hypertension among the treatment groups. The 2- and 5-year overall survival rates for the whole cohort were 27% and 14%, respectively. No significant change was found in 2-year survival for patients diagnosed in each year from 2011 to 2015 (p = 0.250). Also, we found no significant change in proportion of treatment given to patients over the same period (p = 0.432). Conclusion: The poor survival rate of HCC patients in Manitoba could potentially be improved by maximizing the use of local therapy and by implementing multidisciplinary-based case discussion. Efforts should also be directed toward early management of infective, alcoholic, and non-alcoholic steatohepatitis, which will, we hope, lead to a reduction in the incidence of HCC.
Background: Hepatocellular carcinoma (HCC) has a very poor survival rate, especially for those who do not receive a potentially curative therapy. Methods: Treatment details were collected for 320 HCC patients diagnosed in Manitoba between January 2011 and December 2015. Patients had a mean age of 67.3 years, and 71.6% were men. Of these patients, 67 (20.9%) received curative treatment, 36 (11.3%) received non-curative treatment, and 217 (67.8%) received supportive care only; 71.3% of patients had liver cirrhosis. Alcoholic cirrhosis was the most common etiology of chronic liver disease (22.2%). Results: Those who received curative treatment had a significantly lower incidence of portal vein thrombosis and multinodular disease than those in other groups. Patients who received supportive care only had a higher incidence of ascites. We found no difference in the distribution of cirrhosis or portal hypertension among the treatment groups. The 2- and 5-year overall survival rates for the whole cohort were 27% and 14%, respectively. No significant change was found in 2-year survival for patients diagnosed in each year from 2011 to 2015 (p = 0.250). Also, we found no significant change in proportion of treatment given to patients over the same period (p = 0.432). Conclusion: The poor survival rate of HCC patients in Manitoba could potentially be improved by maximizing the use of local therapy and by implementing multidisciplinary-based case discussion. Efforts should also be directed toward early management of infective, alcoholic, and non-alcoholic steatohepatitis, which will, we hope, lead to a reduction in the incidence of HCC.
Authors: Tammy T Chang; Rajiv Sawhney; Alexander Monto; J Ben Davoren; Jacob G Kirkland; Lygia Stewart; Carlos U Corvera Journal: HPB (Oxford) Date: 2008 Impact factor: 3.647
Authors: Alejo Mancebo; M Luisa González-Diéguez; Valle Cadahía; María Varela; Ramón Pérez; Carmen A Navascués; Nieves G Sotorríos; Maribel Martínez; Luis Rodrigo; Manuel Rodríguez Journal: Clin Gastroenterol Hepatol Date: 2012-09-13 Impact factor: 11.382