Impact of viral hepatitis aetiology on survival outcomes in hepatocellular carcinoma: A large multicentre cohort study

Journal of Viral Hepatitis - Tập 24 Số 11 - Trang 982-989 - 2017
S. Mgaieth1, William Kemp1, Paul Gow2, Michael Fink3, John Lubel4, Amanda Nicoll4,5, Alessia Gazzola1, Thai Hong6, Marno Ryan6, Virginia Knight7, Anouk Dev7, Siddharth Sood5, Sally Bell6, Eldho Paul8, Stuart K. Roberts1
1Department of Gastroenterology, Alfred Hospital, Melbourne, VIC, Australia
2Department of Gastroenterology, Austin Hospital, Heidelberg, Vic., Australia
3Department of Surgery, Austin Hospital, Heidelberg, Vic., Australia
4Department of Gastroenterology, Box Hill Hospital, Box Hill, Vic., Australia
5Department of Gastroenterology, Royal Melbourne Hospital, Parkville, Vic., Australia
6Department of Gastroenterology, St. Vincent’s Hospital, Fitzroy, Vic., Australia
7Department of Gastroenterology, Monash Medical Centre, Clayton, Vic., Australia
8Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, Australia

Tóm tắt

SummaryWhile HBV and HCV are risk factors for HCC, uncertainty exists as to whether these viral infections have prognostic significance in HCC. Thus, we compared the overall survival of patients with HBV, HCV and nonviral HCC, and evaluated whether the presence of HBV and HCV predicts patient outcomes. We conducted a multicentre study of HCC cases diagnosed at six Melbourne tertiary hospitals between Jan 2000‐Dec 2014. Patient demographics, liver disease and tumour characteristics and patient outcomes were obtained from hospital databases, computer records and the Victorian Death Registry. Survival outcomes were compared between HBV, HCV and nonviral hepatitis cases and predictors of survival determined using Cox proportional hazards regression. There were 1436 new HCC cases identified including 776 due to viral hepatitis (HBV 235, HCV 511, HBV‐HCV 30) and 660 from nonviral causes. The median survival of HBV, HCV and nonviral HCC patients was 59.1, 28.4 and 20.9 months, respectively (P<.0001). On multivariate analysis, independent risk factors for survival included HCC aetiology, gender, BCLC stage, serum AFP, total number and size of lesions, and serum creatinine and albumin. After adjusting for these and method of detection, HBV remained an independent predictor of improved overall survival when compared to both nonviral (HR 0.60%, 95% CI 0.35‐0.98; P=.03) and HCV‐related HCC (HR 0.51%, 95% CI 0.30‐0.85; P=.01). In this large multicentre study, HBV is independently associated with improved overall survival compared with HCV and nonviral‐related HCC. Further studies are needed to determine the underlying factor(s) responsible.

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Tài liệu tham khảo

10.3322/caac.21262

10.1200/JCO.2008.20.7753

10.1111/j.1440-1746.2006.04459.x

10.1002/hep.27388

10.1053/j.gastro.2011.12.061

10.1002/hep.28267

10.1016/S0140-6736(14)62038-9

10.1002/hep.23485

10.1002/1097-0142(19850815)56:4<918::AID-CNCR2820560437>3.0.CO;2-E

10.1111/j.1478-3231.2008.01957.x

10.1055/s-2007-1007122

Llovet JM, 2002, Prognosis of hepatocellular carcinoma, Hepatogastroenterology, 49, 7

10.1002/hep.24199

10.1002/hep.1840200611

10.1097/MEG.0000000000000527

10.1016/j.jhep.2015.06.012

10.7150/jca.6503

10.1111/jgh.12470

10.1016/S0959-8049(00)00354-3

10.1093/jjco/27.2.67

10.1111/j.1572-0241.2006.00364.x

10.1186/1471-230X-12-64

10.1371/journal.pone.0112184

10.1002/hep.1840120411

10.1053/jhep.2000.17914

10.1136/gut.48.2.251

10.1111/j.1440-1746.2005.03844.x

10.1053/lv.2000.4875

10.1007/s00432-004-0552-0

10.7326/M14-0558

10.1053/gast.2003.50013

10.1056/NEJMoa033364

10.1053/j.gastro.2006.09.020

10.1002/hep.22414

10.1016/j.cgh.2010.11.040

10.1002/hep.23785

10.1016/S0140-6736(12)61425-1

10.1002/hep.26180

10.1007/s00535-009-0093-z

10.1001/archsurg.2011.125

10.1001/2012.jama.11975

10.1111/j.1365-2036.2011.04634.x

10.1200/JCO.2012.48.5896

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Journal of Viral Hepatitis

Tập 24 Số 11

982-989

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