Sex disparities in presentation and prognosis of 1110 patients with hepatocellular carcinoma.
Sex disparities in presentation and prognosis of 1110 patients with hepatocellular carcinoma.
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1110例肝细胞癌患者的性别差异和预后。
DOI：
10.1111/apt.15917
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发表时间：
2020-08
影响因子：
7.6
通讯作者：
Singal AG
中科院分区：
文献类型：
--
作者：
Rich NE;Murphy CC;Yopp AC;Tiro J;Marrero JA;Singal AG
虽然肝细胞癌（HCC）发病率的性别差异已经得到了很好的描述，但研究HCC预后的性别差异的数据有限。为了表征HCC表现和预后的性别差异，我们对2008-2017年在两个美国卫生系统诊断为HCC的连续患者（n=1110，23.5%为女性）进行了回顾性研究。我们使用考克斯比例风险和多变量逻辑回归模型来确定与总生存期、早期肿瘤检测和HCC治疗应答相关的因素（根据改良的实体瘤疗效评价标准[mRECIST]标准）。女性在HCC诊断时年龄较大（平均62.5 vs 59.2岁，p<0.001），早期肿瘤比例较高（53.1% vs 43.7%巴塞罗那临床肝癌[BCLC] 0/A期，p=0.04），但肝功能与男性相似（49.2% vs 47.1% Child Pugh A，p=0.27）。在单变量分析中，女性的总生存期显著优于男性（中位数17.1 vs 12.0个月，p=0.02）。当按年龄分层时，年轻（<65岁）女性的总生存期优于男性（18.3 vs 11.2个月，p=0.02）;然而，老年（≥65岁）女性和男性的总生存期相似（15.5 vs 15.7个月，p=0.45）。在多变量分析中，在校正年龄、人种/种族、甲胎蛋白、BCLC分期、白蛋白-胆红素（ALBI）分级和Child Pugh评分后，女性与较低的死亡率独立相关（风险比[HR] 0.82，95%置信区间[CI] 0.68-0.98）。在次要分析中，调整相同协变量后，女性与早期肿瘤检测（比值比[OR] 1.46，95% CI 1.05-2.02）和首次HCC治疗应答（OR 1.72，95% CI 1.18-2.53）独立相关。在一个大的HCC患者队列中，女性的预后明显好于男性。
Although sex disparities in hepatocellular carcinoma (HCC) incidence have been well described, there are limited data examining sex disparities in HCC prognosis. To characterize sex differences in HCC presentation and prognosis We performed a retrospective study of consecutive patients (n=1110, 23.5% women) diagnosed with HCC between 2008–2017 at two U.S. health systems. We used Cox proportional hazard and multivariable logistic regression models to identify factors associated with overall survival, early tumor detection, and response to HCC treatment (per the modified Response Evaluation Criteria in Solid Tumors [mRECIST] criteria). Women were older at HCC diagnosis (mean 62.5 vs 59.2 years, p<0.001) and had a higher proportion of early stage tumors (53.1% vs 43.7% Barcelona Clinic Liver Cancer [BCLC] stage 0/A, p=0.04), but similar liver function compared to men (49.2% vs 47.1% Child Pugh A, p=0.27). In univariable analysis, women had significantly better overall survival than men (median 17.1 vs 12.0 months, p=0.02). When stratified by age, younger (<65 years) women had better overall survival than men (18.3 vs 11.2 months, p=0.02); however, older (≥65 years) women and men had similar overall survival (15.5 vs 15.7 months, p=0.45). In multivariable analysis, female sex was independently associated with lower mortality after adjusting for age, race/ethnicity, alpha-fetoprotein, BCLC stage, Albumin-Bilirubin (ALBI) grade and Child Pugh score (hazard ratio [HR] 0.82, 95% confidence interval [CI] 0.68–0.98). In secondary analyses, female sex was independently associated with early tumor detection (odds ratio [OR] 1.46, 95% CI 1.05–2.02) and response to first HCC treatment (OR 1.72, 95% CI 1.18–2.53) after adjusting for the same covariates. In a large cohort of patients with HCC, women had significantly better prognosis than men.
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影响因子：
3.1
作者：
Ladenheim MR;Kim NG;Nguyen P;Le A;Stefanick ML;Garcia G;Nguyen MH
通讯作者：
Nguyen MH
影响因子：
2.9
作者：
Mittal S;El-Serag HB
通讯作者：
El-Serag HB
癌症死亡率和生存中的性别差异。
DOI：
10.1158/1055-9965.epi-11-0246
发表时间：
2011-08
期刊：
Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology
影响因子：
--
作者：
Cook MB;McGlynn KA;Devesa SS;Freedman ND;Anderson WF
通讯作者：
Anderson WF
DOI：
10.1016/j.cgh.2020.04.067
发表时间：
2021-01
期刊：
Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association
影响因子：
--
作者：
Balakrishnan M;Patel P;Dunn-Valadez S;Dao C;Khan V;Ali H;El-Serag L;Hernaez R;Sisson A;Thrift AP;Liu Y;El-Serag HB;Kanwal F
通讯作者：
Kanwal F
DOI：
10.6004/jnccn.2018.7105
发表时间：
2019-04-01
影响因子：
13.4
作者：
Hester, Caitlin A.;Rich, Nicole E.;Yopp, Adam C.
通讯作者：
Yopp, Adam C.