Hepatocellular carcinoma confirmation, treatment, and survival in surveillance, epidemiology, and end results registries, 1992-2008.
Hepatocellular carcinoma confirmation, treatment, and survival in surveillance, epidemiology, and end results registries, 1992-2008.
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DOI：
10.1002/hep.24710
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发表时间：
2012-02
期刊：
影响因子：
13.5
通讯作者：
Kleiner, David E.
中科院分区：
文献类型：
--
作者：
Altekruse, Sean F.;McGlynn, Katherine A.;Dickie, Lois A.;Kleiner, David E.
肝细胞癌（HCC）的诊断和治疗方法正在提高生存率。在监测、流行病学和最终结果-13个登记研究中，检查了HCC分期、组织学确认和第一疗程手术。在1998-2008年期间诊断的21，390例HCC病例中，有4，727例（22%）报告了第一疗程侵入性肝脏手术，局部肿瘤破坏或两者兼而有之。局部分期病例中报告肝脏手术或消融的比例为39%，远处/未分期病例中仅为4%。虽然70%的病例有组织学确诊，但与接受消融（81%）或未报告治疗（65%）的病例相比，报告侵入性手术（99%）的病例中确诊的比例更高。从1992年到2008年，未经组织学证实的HCC的发病率比经证实的HCC的发病率增长更快（每年8%对3%）。两个令人鼓舞的发现是，局部期HCC的发病率比区域和远处期HCC的发病率增加得更快（每年8%对4%），报告的第一疗程手术或肿瘤破坏的发病率比未经此类治疗的HCC发病率增加得更快（11%对7%）。在1975-1977年和1998-2007年之间，HCC的5年病因特异性生存率从3%增加到18%。移植受者的存活率为84%，早期接受射频消融的病例为53%，接受切除的病例为47%，接受局部肿瘤破坏的病例为35%。亚裔或太平洋岛民病例的5年生存率（23%）明显高于白色（18%）、西班牙裔（15%）或黑人病例（12%）。随着越来越多的病例在早期得到诊断和治疗，HCC的生存率正在提高。通过继续使用临床监测来跟踪有HCC风险的个体，可能会取得更多进展，从而实现早期干预。
Approaches to the diagnosis and management of hepatocellular carcinoma (HCC) are improving survival. In the Surveillance, Epidemiology and End Results-13 registries, HCC stage, histological confirmation and first course surgery were examined. Among 21,390 HCC cases diagnosed during examined during 1998-2008 there were 4,727 (22%) with reported first course invasive liver surgery, local tumor destruction, or both. The proportion with reported liver surgery or ablation was 39% among localized stage cases and only 4% among distant/unstaged cases. While 70% of cases had histologically confirmed diagnoses, the proportion with confirmed diagnoses was higher among cases with reported invasive surgery (99%) compared to cases receiving ablation (81%) or no reported therapy (65%). Incidence rates of histologically unconfirmed HCC increased faster than those of confirmed HCC from 1992 to 2008 (8% versus 3% per year). Two encouraging findings were that incidence rates of localized stage HCC increased faster than rates of regional and distant stage HCC combined (8% versus 4% per year) and that incidence rates of reported first course surgery or tumor destruction increased faster than incidence rates of HCC without such therapy (11% versus 7%). Between 1975-1977 and 1998-2007, 5-year cause-specific HCC survival increased from just 3% to 18%. Survival was 84% among transplant recipients, 53% among cases receiving radiofrequency ablation at early stage, 47% among cases undergoing resection, and 35% among cases receiving local tumor destruction. Asian or Pacific Islander cases had significantly better 5-year survival (23%) than white (18%), Hispanic (15%), or black cases (12%). HCC survival is improving as more cases are diagnosed and treated at early stages. Additional progress may be possible with continued use of clinical surveillance to follow individuals at risk for HCC, enabling early intervention.
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影响因子：
--
作者：
Mathur, Amit K.;Osborne, Nicholas H.;Sonnenday, Christopher J.
通讯作者：
Sonnenday, Christopher J.
影响因子：
3.1
作者：
Abrams, Peter;Marsh, J. Wallis
通讯作者：
Marsh, J. Wallis
影响因子：
5.1
作者：
McClune, Amy C.;Tong, Myron J.
通讯作者：
Tong, Myron J.
影响因子：
45.3
作者：
Altekruse, Sean F.;McGlynn, Katherine A.;Reichman, Marsha E.
通讯作者：
Reichman, Marsha E.
影响因子：
13.5
作者：
El-Serag, HB;Mason, AC;Key, C
通讯作者：
Key, C