Hepatocellular Carcinoma Survival by Etiology: A SEER-Medicare Database Analysis.
Hepatocellular Carcinoma Survival by Etiology: A SEER-Medicare Database Analysis.
复制标题
DOI：
10.1002/hep4.1564
复制
发表时间：
2020-10
影响因子：
5.1
通讯作者：
Altekruse SF
中科院分区：
文献类型：
--
作者：
Brar G;Greten TF;Graubard BI;McNeel TS;Petrick JL;McGlynn KA;Altekruse SF
在美国，肝细胞癌（HCC）的生存率随肿瘤特征、患者合并症和治疗而变化。HCC病因对生存率的影响尚不清楚。HCC病因和死亡率之间的关系通过监测、流行病学和最终结果-医疗保险数据进行了研究。在2000年至2014年诊断的11，522例HCC病例中，从医疗保险数据中确定了病因，包括代谢紊乱（32.9%），丙型肝炎病毒（8.2%），酒精（4.7%），B肝炎病毒（HBV，2.1%），罕见病因（0.9%），多种病因（26.7%）和未知病因（24.4%）。在调整人口统计学、肿瘤特征、合并症和治疗后，使用考克斯比例风险模型估计HCC病因的风险比（HR）和生存曲线。与HBV相关HCC病例相比，酒精相关HCC患者的死亡率更高（HR 1.49; 95%置信区间[95% CI] 1.25 - 1.77），代谢紊乱相关HCC（HR 1.25; 95% CI 1.07 - 1.47）和多种病因相关HCC（HR 1.25; 95% CI 1.07 - 1.46），但对于丙型肝炎病毒相关、罕见疾病相关和病因不明的HCC无统计学显著性。对于所有HCC病因，中位生存期较短，从酒精的6.1个月到HBV的10.3个月不等。结论：HBV相关HCC的生存率更高。在某种程度上，HCC筛查在HBV感染者中比那些有其他病因风险因素的人更常见，基于人群的HCC筛查，均匀地应用于所有HCC病因类别的人，可以将HCC诊断转移到早期阶段，当临床状态良好的病例更适合治愈治疗时。
In the United States, hepatocellular carcinoma (HCC) survival varies with tumor characteristics, patient comorbidities, and treatment. The effect of HCC etiology on survival is less clearly defined. The relationship between HCC etiology and mortality was examined using Surveillance, Epidemiology, and End Results–Medicare data. In a cohort of 11,522 HCC cases diagnosed from 2000 through 2014, etiologies were identified from Medicare data, including metabolic disorders (32.9%), hepatitis C virus (8.2%), alcohol (4.7%), hepatitis B virus (HBV, 2.1%), rare etiologies (0.9%), multiple etiologies (26.7%), and unknown etiology (24.4%). After adjusting for demographics, tumor characteristics, comorbidities and treatment, hazard ratios (HRs) and survival curves by HCC etiology were estimated using Cox proportional hazard models. Compared with HBV‐related HCC cases, higher mortality was observed for those with alcohol‐related HCC (HR 1.49; 95% confidence interval [95% CI] 1.25‐1.77), metabolic disorder–related HCC (HR 1.25; 95% CI 1.07‐1.47), and multiple etiology‐related HCC (HR 1.25; 95% CI 1.07‐1.46), but was not statistically significant for hepatitis C virus–related, rare disorder–related, and HCC of unknown etiology. For all HCC etiologies, there was short median survival ranging from 6.1 months for alcohol to 10.3 months for HBV. Conclusion: More favorable survival was seen with HBV‐related HCC. To the extent that HCC screening is more common among persons with HBV infection compared to those with other etiologic risk factors, population‐based HCC screening, applied evenly to persons across all HCC etiology categories, could shift HCC diagnosis to earlier stages, when cases with good clinical status are more amenable to curative therapy.
登录
查看更多内容
影响因子：
9.6
作者：
Cauchy, F.;Zalinski, S.;Belghiti, J.
通讯作者：
Belghiti, J.
影响因子：
81.5
作者：
Llovet, Josep M.;Zucman-Rossi, Jessica;Gores, Gregory
通讯作者：
Gores, Gregory
影响因子：
13.5
作者：
Roayaie, Sasan;Obeidat, Khaled;Sposito, Carlo;Mariani, Luigi;Bhoori, Sherrie;Pellegrinelli, Alessandro;Labow, Daniel;Llovet, Josep M.;Schwartz, Myron;Mazzaferro, Vincenzo
通讯作者：
Mazzaferro, Vincenzo
影响因子：
8.4
作者：
Chen, Chien-Hung;Huang, Guan-Tarn;Sheu, Jin-Chuan
通讯作者：
Sheu, Jin-Chuan
DOI：
10.1590/0102-6720201600020010
发表时间：
2016-04
期刊：
Arquivos brasileiros de cirurgia digestiva : ABCD = Brazilian archives of digestive surgery
影响因子：
--
作者：
Lopes Fde L;Coelho FF;Kruger JA;Fonseca GM;Araujo RL;Jeismann VB;Herman P
通讯作者：
Herman P