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Marsh TL, Johnston JM, Homan C, Townshend-Bulson LJ, Kim NJ, VoPham T, Li X, He Q, McMahon BJ, Ioannou GN, Feng Z. HCC surveillance in hepatitis C: A longitudinal algorithm improves alpha-fetoprotein screening. Hepatol Commun 2025; 9:e0719. [PMID: 40408282 PMCID: PMC12106215 DOI: 10.1097/hc9.0000000000000719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2025] [Accepted: 03/26/2025] [Indexed: 05/25/2025] Open
Abstract
BACKGROUND Surveillance for HCC remains important after hepatitis C cure. Improved sensitivity of screening with alpha-fetoprotein (AFP) by using a parametric empirical Bayes (PEB) algorithm, which incorporates an individual patient's longitudinal AFP measurements, was previously demonstrated in a retrospective analysis of clinical trial data prior to widespread hepatitis C cure. METHODS We analyzed de-identified data extracted from the medical records of participants in the Alaska Hepatitis C Study, which aims to enroll all Alaska Native persons living in Alaska with a history of hepatitis C.We compared the performance characteristics of AFP as a screening test using the PEB method versus a fixed cutoff (FC) method in an observational setting, separately for HCC surveillance in active and cured hepatitis C. RESULTS The PEB and FC methods were applied to AFP levels from participants with F3/F4 fibrosis who had active hepatitis C (173 no HCC, 14 HCC) or after they achieved hepatitis C cure (162 no HCC, 12 HCC). Compared to a fixed 20 ng/mL cutoff, demonstrating 91.2% specificity in active hepatitis C, PEB increased sensitivity from 64.3% to 71.4%. After cure, a fixed 7.2 ng/mL cutoff demonstrated 91.2% specificity, and PEB increased sensitivity from 58.3% to 91.7%. CONCLUSIONS The PEB algorithm can increase sensitivity and lead to earlier detection of HCC among patients with F3/F4 fibrosis, both in active and even more so in cured hepatitis C. Lower AFP levels after cure indicate that for either PEB or FC methods, screening parameters, such as cutoffs for a target specificity, should be specified separately by hepatitis C treatment status for HCC surveillance.
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Affiliation(s)
- Tracey L. Marsh
- Biostatistics Program, Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | - Janet M. Johnston
- Liver Disease and Hepatitis Program, Alaska Native Tribal Health Consortium, Anchorage, Alaska, USA
| | - Chriss Homan
- Liver Disease and Hepatitis Program, Alaska Native Tribal Health Consortium, Anchorage, Alaska, USA
| | - Lisa J. Townshend-Bulson
- Liver Disease and Hepatitis Program, Alaska Native Tribal Health Consortium, Anchorage, Alaska, USA
| | - Nicole J. Kim
- Division of Gastroenterology, Department of Medicine, University of Washington, Seattle, Washington, USA
| | - Trang VoPham
- Epidemiology Program, Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | - Xiaohong Li
- Bioinformatics and Epidemiology Program, Vaccine and Infection Disease Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | - Qianchuan He
- Biostatistics Program, Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | - Brian J. McMahon
- Liver Disease and Hepatitis Program, Alaska Native Tribal Health Consortium, Anchorage, Alaska, USA
| | - George N. Ioannou
- Division of Gastroenterology, Department of Medicine, University of Washington, Seattle, Washington, USA
- Division of Gastroenterology, Department of Medicine, Veterans Affairs, Puget Sound Health Care System, Seattle, Washington, USA
| | - Ziding Feng
- Biostatistics Program, Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
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Zhang Q, Liang Q, Xu C. Exploring the association between chemotherapy and prognosis among patients less than 50 years old with hepatocellular carcinoma: a retrospective cohort study based on the SEER database. Discov Oncol 2025; 16:682. [PMID: 40332634 PMCID: PMC12058605 DOI: 10.1007/s12672-025-02490-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2025] [Accepted: 04/24/2025] [Indexed: 05/08/2025] Open
Abstract
BACKGROUND/AIM Hepatic carcinoma, including hepatocellular carcinoma (HCC), is one of the most common malignant tumors globally, with an increasing incidence among younger populations. While chemotherapy is effective for advanced HCC, its impact on the prognosis of younger patients, who typically have better physiological conditions, remains unclear. Younger patients may have different tumor biology and chemotherapy responses than older patients. This study aims to evaluate the impact of chemotherapy on the prognosis and survival rates of younger HCC patients. METHODS A retrospective analysis was conducted using the Surveillance, Epidemiology, and End Results Program (SEER) database, which provides information on cancer statistics among the US population. We selected patients diagnosed with primary HCC between 2010 and 2015. The patients were divided into two groups based on whether they received chemotherapy or not. Kaplan-Meier analyses were utilised to evaluate the impact of chemotherapy on prognosis by comparing the overall survival (OS) and cancer-specific survival (CSS) between the two groups. After performing 1:1 propensity score matching (PSM), the differences in OS and CSS were reassessed. RESULTS Before PSM, there were 1662 participants with primary HCC. After PSM, the sample was reduced to 1154 participants, with 577 individuals in each chemotherapy and non-chemotherapy group. Before PSM, there was no statistically significant difference in OS and CSS between the chemotherapy and non-chemotherapy groups (P = 0.25 and P = 0.06). After PSM, although the survival time in the chemotherapy group was slightly extended, the difference remained statistically insignificant (P = 0.09 and P = 0.38). Kaplan-Meier curves indicated no significant difference between the chemotherapy and non-chemotherapy groups, both before and after PSM, further supporting the conclusion that chemotherapy did not significantly improve survival in young patients with HCC. CONCLUSION Chemotherapy did not significantly improve survival for young patients with HCC. Treatment decisions should be approached cautiously, especially in cases with complex tumor characteristics. Future studies should explore the mechanisms of chemotherapy in younger patients and develop personalized treatment strategies to improve long-term outcomes.
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Affiliation(s)
- Qiyu Zhang
- Department of Interventional Treatment, Beijing NO.6 Hospital, No. 36, North Ertiao, Jiaodaokou, Dongcheng District, Beijing, 100009, China
| | - Qiongyu Liang
- Department of Interventional Treatment, Beijing NO.6 Hospital, No. 36, North Ertiao, Jiaodaokou, Dongcheng District, Beijing, 100009, China
| | - Chi Xu
- Department of Interventional Treatment, Beijing NO.6 Hospital, No. 36, North Ertiao, Jiaodaokou, Dongcheng District, Beijing, 100009, China.
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Vaz J, Hagström H, Eilard MS, Rizell M, Strömberg U. Socioeconomic inequalities in diagnostics, care and survival outcomes for hepatocellular carcinoma in Sweden: a nationwide cohort study. THE LANCET REGIONAL HEALTH. EUROPE 2025; 52:101273. [PMID: 40224376 PMCID: PMC11987686 DOI: 10.1016/j.lanepe.2025.101273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/26/2024] [Revised: 03/05/2025] [Accepted: 03/05/2025] [Indexed: 04/15/2025]
Abstract
Background Hepatocellular carcinoma (HCC) is a leading cause of cancer-related mortality worldwide. This study evaluates how strongly socioeconomic factors associate with diagnostics, treatment, and survival among patients with HCC in Sweden. Methods All adult patients registered with a diagnosis of HCC in the Swedish quality register for liver cancer between 2011 and 2021 were included. Household income was classified as low (first quartile; poorest), medium (second or third quartile), or high (in fourth quartile; wealthiest) based on the overall distribution of household income across all household in Sweden. Outcomes included likelihood of diagnosis under surveillance, early-stage diagnosis (Barcelona Clinic Liver Cancer [BCLC] staging 0-A), and receipt of curative treatment (ablation, resection or liver transplantation), as well as mortality risk. Findings Among 5490 patients, a significant association was found between low household income and decreased likelihood of diagnosis while under surveillance (adjusted odds ratio [aOR] 0·63; 95% confidence interval [CI]: 0·50-0·80), early-stage diagnosis (aOR 0·58; 95% CI: 0·51-0·67), and curative treatment receipt (aOR 0·65; 95% CI: 0·50-0·85). After adjustments for all variables in the BCLC, other sociodemographic variables, comorbidities, and cirrhosis status, patients with low household income had an adjusted hazard ratio for mortality of 1·29 (95% CI: 1·15-1·45) compared to patients with high household income. Interpretation Socioeconomic disparities associate markedly with more advanced stage at HCC diagnosis, less curative treatment, and poorer survival in Sweden. Addressing these disparities through targeted public health interventions may improve HCC care and outcomes in socioeconomically disadvantaged populations. Funding The Swedish Cancer Society-Cancerfonden.
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Affiliation(s)
- Juan Vaz
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Sweden
- Department of Medicine, Huddinge, Karolinska Institutet, Stockholm, Sweden
- Department of Medicine, Halland Hospital Halmstad, Halmstad, Sweden
| | - Hannes Hagström
- Department of Medicine, Halland Hospital Halmstad, Halmstad, Sweden
- Unit of Hepatology, Department of Upper GI Diseases, Karolinska University Hospital, Stockholm, Sweden
| | - Malin Sternby Eilard
- Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Transplantation, Sahlgrenska University Hospital, Region Västra Götaland, Gothenburg, Sweden
| | - Magnus Rizell
- Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Transplantation, Sahlgrenska University Hospital, Region Västra Götaland, Gothenburg, Sweden
| | - Ulf Strömberg
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Sweden
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Hematillake N, Garza MA, Alcala E, Sheikh MY. Metabolic dysfunction-associated steaotic liver disease self-management among the Hispanic/Latino population. Front Public Health 2025; 13:1499467. [PMID: 40356824 PMCID: PMC12066671 DOI: 10.3389/fpubh.2025.1499467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2024] [Accepted: 04/03/2025] [Indexed: 05/15/2025] Open
Abstract
Introduction Hispanic/Latino populations in the U.S. have the highest prevalence of Metabolic Dysfunction-Associated Steaotic Liver Disease (MASLD), and diet and exercise management are crucial for controlling the disease. While quantitative research on general diet and physical activity within this population exists, studies specifically addressing the quantitative analysis of self-management behaviors in Hispanic/Latino individuals with MASLD are notably scarce. This gap underscores the need for our focused investigation into these specific behaviors under the framework of self-management. Objectives Our study aims to investigate how various factors such as age, gender, socioeconomic status, and cultural influences are associated with diet and exercise self-management behaviors in Hispanic/Latino individuals with MASLD. We specifically explore the impact of these demographic and cultural factors as independent variables on the dependent variables of diet and exercise self-management behaviors. Methods This study involved 94 participants who were recruited from the Fresno Clinical Research Center to participate in a cross-sectional analysis designed to explore diet and exercise self-management behaviors among Hispanic/Latino people with MASLD. Data were collected from January 2023 to February 2023 using a 54-item Qualtrics survey. Results The average age of the participants was 53 years. Among the participants, 68.1% self- identified as female, and 80.9% had an annual income of at least $35,000. Age b = 0.074, p ≤ 0.001, gender b = 1.242, p ≤ 0.05, and financial stress b = 1.887 p ≤ 0.01 were predictors for poor exercise self-management behaviors. Disease-related knowledge b = -2.264 p ≤ 0.001, and familism b = -0.344 p ≤ 0.05 were predictors for healthy exercise self-management behaviors. There were no significant predictors for diet self-management behaviors among the variables observed in this study. Conclusion Age, gender, and financial stress predicted poor exercise self-management behaviors, while disease-related knowledge and familism predicted healthy exercise self-management behaviors.
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Affiliation(s)
- Naomi Hematillake
- Department of Public Health, College of Health and Human Services, California State University, Fresno, CA, United States
| | - Mary A. Garza
- Department of Public Health, College of Health and Human Services, California State University, Fresno, CA, United States
- College of Health and Human Services, Central Valley Health Policy Institute (CVHPI), California State University, Fresno, CA, United States
| | - Emanuel Alcala
- College of Health and Human Services, Central Valley Health Policy Institute (CVHPI), California State University, Fresno, CA, United States
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Moon AM, Lupu GV, Green EW, Deutsch-Link S, Henderson LM, Sanoff HK, Yanagihara TK, Kokabi N, Mauro DM, Barritt AS. Rural-Urban Disparities in Hepatocellular Carcinoma Deaths Are Driven by Hepatitis C-Related Hepatocellular Carcinoma. Am J Gastroenterol 2025:00000434-990000000-01703. [PMID: 40214295 DOI: 10.14309/ajg.0000000000003487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2024] [Accepted: 03/28/2025] [Indexed: 05/11/2025]
Abstract
INTRODUCTION Recent data suggest emerging rural-urban disparities in hepatocellular carcinoma (HCC) burden in the United States. We aimed to assess (i) trends in rural vs urban HCC-related mortality and (ii) differences in underlying chronic liver disease etiologies contributing to HCC-related deaths. METHODS We used the National Vital Statistics System to examine crude and age-adjusted HCC death rates overall and by etiology for rural and urban residents from 2005 to 2023. Using the National Cancer Institute Joinpoint Trend Analysis Software, we identified statistically significant changes in annual percentage change (APC) in HCC mortality rates. RESULTS Examining mortality rates over time, average APC in HCC deaths was significantly higher in rural residents (crude average annual percentage change [AAPC] 4.64, 95% confidence interval [CI] 4.10, 5.34; age-adjusted AAPC 3.53, 95% CI 3.09, 4.07) compared with urban residents (crude AAPC 2.72, 95% CI 2.43, 3.01; age-adjusted AAPC 1.68, 95% CI 1.28, 2.13). Differences in HCC death rate changes were driven by a significantly greater recent decline in HCC cases from hepatitis C virus (HCV) in urban residents (crude APC -6.69, 95% CI -8.85, -5.30 from 2017 to 2023) compared with rural residents (crude APC -3.31, 95% CI -8.05, 0.73 from 2016 to 2023). DISCUSSION Annual increases in HCC deaths have been more pronounced in rural compared with urban populations. Deaths from HCV-related HCC have declined with a geographical disparity that favors urban populations, possibly driven by decreased access to HCV screening or availability of highly effective direct-acting antiviral therapies for rural residents. These findings underscore the need for targeted HCV screening and treatment strategies in rural populations in addition to ongoing strategies to combat alcohol use and metabolic diseases.
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Affiliation(s)
- Andrew M Moon
- Division of Gastroenterology and Hepatology, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, USA
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Gabriel V Lupu
- Division of Gastroenterology and Hepatology, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, USA
| | - Ellen W Green
- Division of Gastroenterology and Hepatology, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, USA
| | - Sasha Deutsch-Link
- Division of Gastroenterology and Hepatology, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, USA
| | - Louise M Henderson
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, North Carolina, USA
- Department of Radiology, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Hanna K Sanoff
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, North Carolina, USA
- Department of Medicine, Division of Oncology, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, USA
| | - Ted K Yanagihara
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, North Carolina, USA
- Department of Radiation Oncology, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Nima Kokabi
- Division of Interventional Radiology, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, USA
| | - David M Mauro
- Division of Interventional Radiology, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, USA
| | - A Sidney Barritt
- Division of Gastroenterology and Hepatology, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, USA
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Wehrle CJ, Burns K, Ong E, Couillard A, Parikh ND, Caoili E, Kim J, Aucejo F, Schlegel A, Knott E, Laeseke P, Boudreaux JP, von Breitenbuch P, Silk M, Alassas M, Guzowski A, Fuller B, Koepsel EK, Hewitt B, Mendiratta-Lala M, Kwon DCH. The first international experience with histotripsy: a safety analysis of 230 cases. J Gastrointest Surg 2025; 29:102000. [PMID: 39978577 DOI: 10.1016/j.gassur.2025.102000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2025] [Revised: 02/08/2025] [Accepted: 02/15/2025] [Indexed: 02/22/2025]
Abstract
BACKGROUND Histotripsy is a novel, noninvasive, nonionizing, and nonthermal approach that uses focused ultrasound waves to treat liver tumors. This technology received a de novo Food and Drug Administration grant in late 2023. This study aimed to provide the first report on post-trial real-world clinical safety data. METHODS Safety outcomes within 30 days of histotripsy were collected after obtaining Food and Drug Administration clearance (December 22, 2023 to July 26, 2024). All centers that performed histotripsy were invited to participate in this study. Complications requiring treatment were graded using the Clavien-Dindo classification and Comprehensive Complication Index (CCI). RESULTS A total of 295 patients underwent histotripsy for 510 tumors at 18 centers. The treated liver tumor types included colorectal metastases (n = 140), neuroendocrine tumors (n = 46), hepatocellular carcinomas (n = 31), pancreatic tumors (n = 30), and breast metastases (n = 26). The most common numbers of tumors treated per procedure were 1 (n = 170), 2 (n = 69), and 3 (n = 37). All 8 liver segments were treated for tumors. Safety data were available for 230 patients from 9 centers. Of note, 12 of 230 patients (5.2%) experienced complications of any grade. Most patients (9 [75%]) had minor cases (Clavien-Dindo grade ≤ II). The median and mean CCIs were 0.00 (IQR, 0.00-0.00) and 0.00 (95% CI, 0.00-0.75). All 3 major complications (Clavien-Dindo grade > II [1.3%]) were death due to disease progression. All 3 patients underwent histotripsy with palliative intent for known advanced intra- and extrahepatic diseases. CONCLUSION To the best of our knowledge, this is the first study to report on the real-world therapeutic use of histotripsy for liver tumors. Histotripsy was well tolerated, with few overall complications and rare serious complications, indicating a safety profile that compares favorably with that of other liver-directed and surgical therapies for the treatment of liver tumors. Long-term follow-up data, including oncologic outcomes, were collected.
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Affiliation(s)
- Chase J Wehrle
- Division of Hepatopancreatobiliary Surgery and Liver Transplantation, Cleveland Clinic, Cleveland, OH, United States.
| | - Kevin Burns
- Department of Interventional Radiology, Mission Community Hospital, Los Angeles, CA, United States
| | - Evan Ong
- Division of Surgical Oncology, Swedish Health Services, Seattle, WA, United States
| | - Allison Couillard
- Department of Interventional Radiology, University of Wisconsin - Madison, Madison, WI, United States
| | - Neehar D Parikh
- Division of Gastroenterology and Hepatology, University of Michigan, Ann Arbor, MI, United States
| | - Elaine Caoili
- Division of Abdominal and Cross-Sectional Interventional Radiology, University of Michigan, Ann Arbor, MI, United States
| | - JaeKeun Kim
- Division of Hepatopancreatobiliary Surgery and Liver Transplantation, Cleveland Clinic, Cleveland, OH, United States
| | - Federico Aucejo
- Division of Hepatopancreatobiliary Surgery and Liver Transplantation, Cleveland Clinic, Cleveland, OH, United States
| | - Andrea Schlegel
- Division of Hepatopancreatobiliary Surgery and Liver Transplantation, Cleveland Clinic, Cleveland, OH, United States
| | - Emily Knott
- Division of Hepatopancreatobiliary Surgery and Liver Transplantation, Cleveland Clinic, Cleveland, OH, United States
| | - Paul Laeseke
- Department of Interventional Radiology, University of Wisconsin - Madison, Madison, WI, United States
| | - J Philip Boudreaux
- New Orleans Louisiana Neuroendocrine Tumor Specialists, Louisiana State University Health Center, New Orleans, LA, United States
| | - Philipp von Breitenbuch
- Department of Surgery, Sheikh Tahnoon Bin Mohammed Medical City, Al Ain, United Arab Emirates
| | - Mikhail Silk
- Division of Interventional Radiology, New York University Langone Health, New York, NY, United States
| | - Mohamed Alassas
- Division of Surgical Oncology, Swedish Health Services, Seattle, WA, United States
| | - Andrew Guzowski
- Division of Hepatopancreatobiliary and Advanced Gastrointestinal Surgery, AdventHealth, Orlando, FL, United States
| | - Brian Fuller
- Department of Interventional Radiology, Mission Community Hospital, Los Angeles, CA, United States
| | - Erica Knavel Koepsel
- Department of Interventional Radiology, University of Wisconsin - Madison, Madison, WI, United States
| | - Brock Hewitt
- Division of Surgical Oncology, New York University Langone Health, New York, NY, United States
| | - Mishal Mendiratta-Lala
- Division of Abdominal and Cross-Sectional Interventional Radiology, University of Michigan, Ann Arbor, MI, United States
| | - David C H Kwon
- Division of Hepatopancreatobiliary Surgery and Liver Transplantation, Cleveland Clinic, Cleveland, OH, United States
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Jiang Z, Zeng G, Dai H, Bian Y, Wang L, Cao W, Yang J. Global, regional and national burden of liver cancer 1990-2021: a systematic analysis of the global burden of disease study 2021. BMC Public Health 2025; 25:931. [PMID: 40057711 PMCID: PMC11890516 DOI: 10.1186/s12889-025-22026-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2024] [Accepted: 02/19/2025] [Indexed: 05/13/2025] Open
Abstract
BACKGROUND Liver cancer is a growing global health issue, with significant geographical disparities in prevalence and mortality. Understanding these differences is key to developing effective prevention and treatment strategies. METHODS We analyzed liver cancer trends from 1990 to 2021 across 204 countries using data from the Global Burden of Disease (GBD) study. We modeled mortality from vital registration data and estimated non-fatal burden using primary studies, hospital discharges, and claims data. We calculated prevalence, mortality, YLLs, YLDs, and DALYs, adjusting for age and reporting rates per 100,000 population with 95% UI. FINDINGS In 2021, there were 739,299 (673114-821948) cases of liver cancer worldwide. The age-standardized prevalence rate increased from (7.75 [6.91-8.43] per 100,000 people) in 1990 to (8.68[7.90-9.67] per 100,000 people) in 2021, while the mortality rate slightly decreased from(4.48 [4.10-4.93] per 100,000 people) to (6.13 [5.58-6.84] per 100,000 people). High-income North America had the highest prevalence rate, and Southern Latin America had the lowest. Mongolia had the highest prevalence and mortality rates, while Morocco had the lowest. The total YLDs attributed to liver cancer nearly tripled from 1990 to 2021, and the age-standardized DALY rate decreased. In the frontier analysis, countries or regions with higher SDI have greater potential for burden improvement. In the frontier analysis of SDI and age-standardized liver cancer DALY rates in 2021, countries with higher SDI (> 0.85) and higher effective differences relative to their level of development include America, Canada, Germany, Netherlands, etc., while frontier countries with lower SDI (< 0.5) and lower effective differences include Somalia, Papua New Guinea, Yemen, Lao People's Democratic Republic, etc. Countries with larger effective differences include Togo, Gambia, Australia, Norway, etc. CONCLUSION: The global burden of liver cancer is decreasing, but the prevalence of liver cancer is increasing, with significant differences across regions worldwide. These findings can inform health policy and research to address this global challenge. INTERPRETATION From 1990 to 2021, the incidence of liver cancer in many regions has increased significantly, which is expected to impose a huge social and economic burden on governments and health systems in the coming years. Our research findings may assist policymakers in devising strategies to combat liver cancer, including educating professionals to address the burden of this complex disease.
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Affiliation(s)
- Zhichao Jiang
- Department of General Surgery, Shidong Hospital, Shidong Hospital, University of Shanghai for Science and Technology, Yangpu District, 999 Shiguang Road, Shanghai, 200438, China
| | - Guoqiang Zeng
- Department of Andrology, The First Hospital of Jilin University, Changchun, 130021, Jilin Province, China
| | - Huajia Dai
- Department of General Surgery, Shidong Hospital, Shidong Hospital, University of Shanghai for Science and Technology, Yangpu District, 999 Shiguang Road, Shanghai, 200438, China
| | - Yuhao Bian
- Department of General Surgery, Shidong Hospital, Shidong Hospital, University of Shanghai for Science and Technology, Yangpu District, 999 Shiguang Road, Shanghai, 200438, China
| | - Libin Wang
- Department of General Surgery, Shidong Hospital, Shidong Hospital, University of Shanghai for Science and Technology, Yangpu District, 999 Shiguang Road, Shanghai, 200438, China
| | - Wei Cao
- Department of General Surgery, Shidong Hospital, Shidong Hospital, University of Shanghai for Science and Technology, Yangpu District, 999 Shiguang Road, Shanghai, 200438, China
| | - Junfeng Yang
- Department of General Surgery, Shidong Hospital, Shidong Hospital, University of Shanghai for Science and Technology, Yangpu District, 999 Shiguang Road, Shanghai, 200438, China.
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Sererols-Viñas L, Garcia-Vicién G, Ruiz-Blázquez P, Lee TF, Lee YA, Gonzalez-Sanchez E, Vaquero J, Moles A, Filliol A, Affò S. Hepatic Stellate Cells Functional Heterogeneity in Liver Cancer. Semin Liver Dis 2025; 45:33-51. [PMID: 40043738 DOI: 10.1055/a-2551-0724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/01/2025]
Abstract
Hepatic stellate cells (HSCs) are the liver's pericytes, and play key roles in liver homeostasis, regeneration, fibrosis, and cancer. Upon injury, HSCs activate and are the main origin of myofibroblasts and cancer-associated fibroblasts (CAFs) in liver fibrosis and cancer. Primary liver cancer has a grim prognosis, ranking as the third leading cause of cancer-related deaths worldwide, with hepatocellular carcinoma (HCC) being the predominant type, followed by intrahepatic cholangiocarcinoma (iCCA). Moreover, the liver hosts 35% of all metastatic lesions. The distinct spatial distribution and functional roles of HSCs across these malignancies represent a significant challenge for universal therapeutic strategies, requiring a nuanced and tailored understanding of their contributions. This review examines the heterogeneous roles of HSCs in liver cancer, focusing on their spatial localization, dynamic interactions within the tumor microenvironment (TME), and emerging therapeutic opportunities, including strategies to modulate their activity, and harness their potential as targets for antifibrotic and antitumor interventions.
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Affiliation(s)
- Laura Sererols-Viñas
- Tumor Microenvironment Plasticity and Heterogeneity Research Group, Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- University of Barcelona, Barcelona, Spain
| | - Gemma Garcia-Vicién
- Tumor Microenvironment Plasticity and Heterogeneity Research Group, Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Paloma Ruiz-Blázquez
- University of Barcelona, Barcelona, Spain
- Tissue Remodeling Fibrosis and Cancer Group, Institute of Biomedical Research of Barcelona, Spanish National Research Council, Barcelona, Spain
- Institute of Biomedical Research of Barcelona (IDIBAPS), Barcelona, Spain
- CIBEREHD, National Biomedical Research Institute on Liver and Gastrointestinal Diseases, Instituto de Salud Carlos III, Madrid, Spain
| | - Ting-Fang Lee
- Department of Surgery, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Youngmin A Lee
- Department of Surgery, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Ester Gonzalez-Sanchez
- HepatoBiliary Tumours Lab, Centro de Investigación del Cáncer and Instituto de Biología Molecular y Celular del Cáncer, CSIC-Universidad de Salamanca, Salamanca, Spain
- Department of Physiology and Pharmacology, University of Salamanca, Salamanca, Spain
| | - Javier Vaquero
- CIBEREHD, National Biomedical Research Institute on Liver and Gastrointestinal Diseases, Instituto de Salud Carlos III, Madrid, Spain
- HepatoBiliary Tumours Lab, Centro de Investigación del Cáncer and Instituto de Biología Molecular y Celular del Cáncer, CSIC-Universidad de Salamanca, Salamanca, Spain
- TGF-β and Cancer Group, Oncobell Program, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain
| | - Anna Moles
- Tissue Remodeling Fibrosis and Cancer Group, Institute of Biomedical Research of Barcelona, Spanish National Research Council, Barcelona, Spain
- Institute of Biomedical Research of Barcelona (IDIBAPS), Barcelona, Spain
- CIBEREHD, National Biomedical Research Institute on Liver and Gastrointestinal Diseases, Instituto de Salud Carlos III, Madrid, Spain
| | - Aveline Filliol
- Department of Cancer Biology and Genetics, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Silvia Affò
- Tumor Microenvironment Plasticity and Heterogeneity Research Group, Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
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9
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Wu C, Targher G, Byrne CD, Mao Y, Cheung TT, Yilmaz Y, Valenti L, Méndez-Sánchez N, Sookoian S, Chan WK, Treeprasertsuk S, Yu HH, Kim SU, George J, Hu D, Sebastiani G, Ryan JD, Oviedo RJ, Zhong JH, Schattenberg JM, Lonardo A, Ruiz-Úcar E, Seto WK, Sotoudeheian M, Ocama P, Lupşor-Platon M, Yang T, Ghazinyan H, Pan Q, Hamid S, Adams L, Chai J, Prasad A, Perera N, Alswat K, Isakov V, Sarin SK, Sharara AI, Sanai FM, Al-Busafi SA, Opio CK, Toro-Huamanchumo CJ, Yang W, Wong YJ, Torzilli G, Fouad Y, Zheng MH. Global, Regional, and National Burden of Primary Liver Cancer Attributable to Metabolic Risks: An Analysis of the Global Burden of Disease Study 1990-2021. Am J Gastroenterol 2025:00000434-990000000-01520. [PMID: 39749919 DOI: 10.14309/ajg.0000000000003288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2024] [Accepted: 11/15/2024] [Indexed: 01/04/2025]
Abstract
INTRODUCTION The global burden of metabolic diseases is increasing, but estimates of their impact on primary liver cancer are uncertain. We aimed to assess the global burden of primary liver cancer attributable to metabolic risk factors, including high body mass index (BMI) and high fasting plasma glucose (FPG) levels, between 1990 and 2021. METHODS The total number and age-standardized rates of deaths and disability-adjusted life years (DALYs) from primary liver cancer attributable to each metabolic risk factor were extracted from the Global Burden of Disease Study 1990-2021. The metabolic burden trends of liver cancer across regions and countries by sociodemographic index (SDI) and sex were estimated. The annual percentage changes in age-standardized DALYs rate were also calculated. RESULTS Globally, in 2021, primary liver cancer attributable to high BMI and/or high FPG was estimated to have caused 59,970 deaths (95% uncertainty interval [UI] 20,567-104,103) and 1,540,437 DALYs (95% UI 540,922-2,677,135). The age-standardized rates of death and DALYs were 0.70 (95% UI 0.24-1.21) and 17.64 (95% UI 6.19-30.65) per 100,000 person-years. A consistent global rise in liver cancer attributable to metabolic risks was observed from 1990 to 2021, with high BMI identified as the major contributing risk factor. The highest burden of deaths and DALYs of liver cancer consistently occurred in high SDI countries, while the fastest growth trends were observed in low-middle SDI countries. The burdens of high levels of BMI and FPG were higher in men than in women. DISCUSSION Primary liver cancer attributable to high BMI and/or high FPG imposes an increasingly substantial clinical burden on global public health, particularly in high SDI countries. Rapid growth trends are also found in middle SDI countries.
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Affiliation(s)
- Chutian Wu
- Department of Gastroenterology, The Fifth Affiliated Hospital, Guangzhou Medical University, Guangzhou, China
| | - Giovanni Targher
- Department of Medicine, University of Verona, Verona, Italy
- Metabolic Diseases Research Unit, IRCSS Sacro Cuore - Don Calabria Hospital, Negrar di Valpolicella, Italy
| | - Christopher D Byrne
- Southampton National Institute for Health and Care Research Biomedical Research Centre, University Hospital Southampton and University of Southampton, Southampton General Hospital, Southampton, UK
| | - Yilei Mao
- Department of Liver Surgery, Peking Union Medical College (PUMC) Hospital, Peking Union Medical College (PUMC) & Chinese Academy of Medical Sciences (CAMS), Beijing, China
| | - Tan To Cheung
- Department of Surgery, Queen Mary Hospital, The University of Hong Kong, Hong Kong, China
| | - Yusuf Yilmaz
- Department of Gastroenterology, School of Medicine, Recep Tayyip Erdoğan University, Rize, Türkiye
| | - Luca Valenti
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
- Precision Medicine and Biological Resource Center, Fondazione IRCCS Ca' Granda Ospedale Policlinico Milano, Milan, Italy
| | - Nahum Méndez-Sánchez
- Liver Research Unit, Medica Sur Clinic & Foundation and Faculty of Medicine, National Autonomous University of Mexico, Mexico City, Mexico
| | - Silvia Sookoian
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina
- Faculty of Health Science, Maimónides University, Buenos Aires, Argentina
- Clinical and Molecular Hepatology, Translational Health Research Center (CENITRES), Maimónides University, Buenos Aires, Argentina
| | - Wah-Kheong Chan
- Gastroenterology and Hepatology Unit, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | | | - Hon Ho Yu
- Department of Gastroenterology and Hepatology, Kiang Wu Hospital, Macau, China
| | - Seung Up Kim
- Department of Internal Medicine, Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, South Korea
| | - Jacob George
- Storr Liver Centre, Westmead Institute for Medical Research, Westmead Hospital and University of Sydney, Sydney, Australia
| | - Dandan Hu
- Department of Liver Surgery, Sun Yat-Sen University Cancer Center, Guangzhou, China
| | - Giada Sebastiani
- Division of Gastroenterology and Hepatology, Chronic Viral Illness Service, McGill University Health Centre, Royal Victoria Hospital, Montreal, Canada
| | - John D Ryan
- Department of Hepatology, RCSI School of Medicine and Medical Sciences, Beaumont Hospital, Dublin, Ireland
| | - Rodolfo J Oviedo
- Nacogdoches Center for Metabolic & Weight Loss Surgery, Nacogdoches Medical Center, Nacogdoches, Texas, USA
| | - Jian-Hong Zhong
- Department of Hepatobiliary Surgery, Guangxi Medical University Cancer Hospital, Nanning, China
| | - Jörn M Schattenberg
- Department of Internal Medicine II, Saarland University Medical Center, Homburg, Germany
| | - Amedeo Lonardo
- Department of Internal Medicine, Ospedale Civile di Baggiovara (-2023), Azienda Ospedaliero-Universitaria di Modena, Modena, Italy
| | - Elena Ruiz-Úcar
- Department of Metabolic, Bariatric and Endocrine Surgery, Fuenlabrada University Hospital, Madrid, Spain
| | - Wai-Kay Seto
- Department of Medicine, School of Clinical Medicine, The University of Hong Kong, Hong Kong, China
- Department of Medicine, The University of Hong Kong-Shenzhen Hospital, Shenzhen, China
- State Key Laboratory of Liver Research, The University of Hong Kong, Hong Kong, China
| | - Mohammadjavad Sotoudeheian
- Physiology Research Center, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran
- Department of General Medicine, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Ponsiano Ocama
- Department of Medicine, Makerere University of College of Health Sciences, Kampala, Uganda
| | - Monica Lupşor-Platon
- Department of Medical Imaging, "Prof. Dr. Octavian Fodor" Regional Institute of Gastroenterology and Hepatology, "Iuliu Haţieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Tian Yang
- Department of Hepatobiliary Surgery, Eastern Hepatobiliary Surgery Hospital, Naval Medical University, Shanghai, China
| | - Hasmik Ghazinyan
- Gastroenterology and Hepatology Service, Yerevan Scientific Medical Center, Yerevan, Armenia
| | - Qiuwei Pan
- Department of Gastroenterology and Hepatology, Erasmus MC-University Medical Center, Rotterdam, the Netherlands
| | - Saeed Hamid
- Department of Medicine, Aga Khan University, Karachi, Pakistan
| | - Leon Adams
- Department of Hepatology, Sir Charles Gairdner Hospital, Perth, Australia
- Medical School, The University of Western Australia, Perth, Australia
| | - Jin Chai
- Department of Gastroenterology, The First Affiliated Hospital (Southwest Hospital), Third Military Medical University (Army Medical University), Chongqing, China
- Institute of Digestive Diseases of PLA, The First Affiliated Hospital (Southwest Hospital), Third Military Medical University (Army Medical University), Chongqing, China
- Cholestatic Liver Diseases Center and Center for Metabolic-Associated Fatty Liver Disease, The First Affiliated Hospital (Southwest Hospital), Third Military Medical University (Army Medical University), Chongqing, China
| | - Arun Prasad
- Surgical Gastroenterology, Bariatric and Robotic Surgery, Apollo Hospital, New Delhi, India
| | - Nilanka Perera
- Department of Medicine, University of Sri Jayewardenepura, Nugegoda, Sri Lanka
| | - Khalid Alswat
- Liver Disease Research Center, Department of Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Vasily Isakov
- Department of Gastroenterology and Hepatology, Federal Research Center for Nutrition, Biotechnology and Food Safety, Moscow, Russian Federation
| | - Shiv Kumar Sarin
- Department of Hepatology and Liver Transplant, Institute of Liver and Biliary Sciences, New Delhi, India
| | - Ala I Sharara
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Faisal M Sanai
- Gastroenterology Section, Department of Medicine, King Abdulaziz Medical City, King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
| | - Said A Al-Busafi
- Department of Medicine, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Oman
| | | | - Carlos Jesus Toro-Huamanchumo
- Universidad San Ignacio de Loyola, Lima, Peru
- OBEMET Center for Obesity and Metabolic Health, Lima, Peru
- Nutrition and Health Innovation Research Institute, School of Medical and Health Sciences, Edith Cowan University, Western Australia, Australia
| | - Wah Yang
- Department of Metabolic and Bariatric Surgery, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Yu Jun Wong
- Department of Gastroenterology & Hepatology, Changi General Hospital, Singapore
- Duke-NUS Medical School, Singapore
| | - Guido Torzilli
- Department of Surgery, Humanitas University, School of Medicine, Milano, Italy
| | - Yasser Fouad
- Department of Gastroenterology, Hepatology and Endemic Medicine, Faculty of Medicine, Minia University, Minia, Egypt
| | - Ming-Hua Zheng
- MAFLD Research Center, Department of Hepatology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
- Key Laboratory of Diagnosis and Treatment for The Development of Chronic Liver Disease in Zhejiang Province, Wenzhou, China
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10
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Menezes TP, Prates MO, Assunção R, De Castro MSM. Latent Archetypes of the Spatial Patterns of Cancer. Stat Med 2024; 43:5115-5137. [PMID: 39362794 PMCID: PMC11583956 DOI: 10.1002/sim.10232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 08/02/2024] [Accepted: 09/13/2024] [Indexed: 10/05/2024]
Abstract
The cancer atlas edited by several countries is the main resource for the analysis of the geographic variation of cancer risk. Correlating the observed spatial patterns with known or hypothesized risk factors is time-consuming work for epidemiologists who need to deal with each cancer separately, breaking down the patterns according to sex and race. The recent literature has proposed to study more than one cancer simultaneously looking for common spatial risk factors. However, this previous work has two constraints: they consider only a very small (2-4) number of cancers previously known to share risk factors. In this article, we propose an exploratory method to search for latent spatial risk factors of a large number of supposedly unrelated cancers. The method is based on the singular value decomposition and nonnegative matrix factorization, it is computationally efficient, scaling easily with the number of regions and cancers. We carried out a simulation study to evaluate the method's performance and apply it to cancer atlas from the USA, England, France, Australia, Spain, and Brazil. We conclude that with very few latent maps, which can represent a reduction of up to 90% of atlas maps, most of the spatial variability is conserved. By concentrating on the epidemiological analysis of these few latent maps a substantial amount of work is saved and, at the same time, high-level explanations affecting many cancers simultaneously can be reached.
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Affiliation(s)
| | | | - Renato Assunção
- ESRI Inc., Redlands, California, USA
- Departamento de Ciência da Computação, UFMG, Belo Horizonte, Minas Gerais, Brazil
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11
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Ozbay MF, Harputluoglu H, Karaca M, Tekin O, Şendur MAN, Kaplan MA, Sahin B, Geredeli C, Teker F, Tural D, Saglam S, Çil T, Bilici A, Erol C, Kalkan Z, Bayram E, Selvi O, Gültürk İ, Göksu SS, Tatlı AM. Sequential Use of Sorafenib and Regorafenib in Hepatocellular Cancer Recurrence After Liver Transplantation: Treatment Strategies and Outcomes. Cancers (Basel) 2024; 16:3880. [PMID: 39594835 PMCID: PMC11592833 DOI: 10.3390/cancers16223880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2024] [Revised: 11/14/2024] [Accepted: 11/16/2024] [Indexed: 11/28/2024] Open
Abstract
BACKGROUND AND AIMS During liver transplantation, hepatocellular carcinoma (HCC) recurrence remains a critical challenge for patient survival. Targeted therapies, such as sorafenib and regorafenib, have been utilized to manage relapsed HCC in this unique setting. This study aimed to assess the efficacy of Sorafenib and Regorafenib in patients with HCC who experienced recurrence after liver transplantation. We focused on survival outcomes, treatment responses, and the management of side effects in this patient group. METHODS We conducted a retrospective analysis of 73 patients who experienced HCC recurrence post-liver transplantation between 2012 and 2022 across 11 oncology centers in Turkey. Patients were categorized according to Child-Pugh classification and treated with sorafenib as first-line therapy and Regorafenib in case of progression. Survival rates were analyzed using the Kaplan-Meier method, and risk factors were evaluated using Cox regression analysis. RESULTS Of the 73 patients included in the study, 62 were male (84.9%), and 11 were female (15.1%), with a mean age of 61.5 ± 10.9 years. All patients received sorafenib as first-line treatment. Among patients who experienced progression with sorafenib or discontinued treatment due to toxicity, 45.2% (n = 33) continued treatment with regorafenib. The median progression-free survival (PFS1) time with sorafenib was 5.6 months, and the one-year survival rate was 24.3%. The median progression-free survival (PFS2) time with regorafenib, which was administered as second-line treatment, was also calculated as 5.9 months. Overall survival (OS) duration was determined as 35.9 months. The most common side effects associated with both drugs included fatigue, hand and foot syndrome, and hypertension. Significantly better survival outcomes were shown in the Child-Pugh A group compared to other patients. CONCLUSIONS These results suggest that Sorafenib and Regorafenib treatments offer a survival advantage in patients with relapsed HCC post-transplantation. However, individualized treatment strategies and close follow-up are crucial for optimizing outcomes. Further studies are needed to refine therapeutic protocols and enhance the care of this specific patient group.
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Affiliation(s)
- Mehmet Fatih Ozbay
- Department of Medical Oncology, Kırsehir Training and Research Hospital, Kirsehir 40200, Turkey;
| | - Hakan Harputluoglu
- Department of Medical Oncology, Faculty of Medicine, Inonu University, Malatya 44000, Turkey
| | - Mustafa Karaca
- Department of Medical Oncology, Faculty of Medicine, Akdeniz University, Antalya 07070, Turkey; (S.S.G.); (A.M.T.)
| | - Omer Tekin
- Department of Medical Oncology, Faculty of Medicine, Inonu University, Malatya 44000, Turkey
| | - Mehmet Ali Nahit Şendur
- Department of Medical Oncology, Republic of Turkey Ministry of Health Ankara Bilkent City Hospital, Ankara 06800, Turkey
| | - Muhammed Ali Kaplan
- Department of Medical Oncology, Faculty of Medicine, Dicle University, Diyarbakır 21280, Turkey
| | - Berksoy Sahin
- Department of Medical Oncology, Faculty of Medicine, Çukurova University, Adana 01330, Turkey
| | - Caglayan Geredeli
- Department of Medical Oncology, Health Sciences University Okmeydanı Training and Research Hospital, Istanbul 34098, Turkey
| | - Fatih Teker
- Department of Medical Oncology, Faculty of Medicine, Gaziantep University, Gaziantep 27410, Turkey
| | - Deniz Tural
- Department of Medical Oncology, Bakırköy Sadi Konuk Training and Research Hospital, Istanbul 34147, Turkey
| | - Sezer Saglam
- Department of Medical Oncology, Demiroglu Bilim University Gayrettepe Florence Nightingale Hospital, Istanbul 34394, Turkey
| | - Timuçin Çil
- Department of Medical Oncology, Adana City Training and Research Hospital, Adana Faculty of Medicine, University of Health Sciences, Adana 01230, Turkey
| | - Ahmet Bilici
- Department of Medical Oncology, Istanbul Medipol University, Istanbul 34815, Turkey
| | - Cihan Erol
- Department of Medical Oncology, Republic of Turkey Ministry of Health Ankara Bilkent City Hospital, Ankara 06800, Turkey
| | - Ziya Kalkan
- Department of Medical Oncology, Faculty of Medicine, Dicle University, Diyarbakır 21280, Turkey
| | - Ertugrul Bayram
- Department of Medical Oncology, Faculty of Medicine, Çukurova University, Adana 01330, Turkey
| | - Oguzhan Selvi
- Department of Medical Oncology, Health Sciences University Okmeydanı Training and Research Hospital, Istanbul 34098, Turkey
| | - İlkay Gültürk
- Department of Medical Oncology, Bakırköy Sadi Konuk Training and Research Hospital, Istanbul 34147, Turkey
| | - Sema Sezgin Göksu
- Department of Medical Oncology, Faculty of Medicine, Akdeniz University, Antalya 07070, Turkey; (S.S.G.); (A.M.T.)
| | - Ali Murat Tatlı
- Department of Medical Oncology, Faculty of Medicine, Akdeniz University, Antalya 07070, Turkey; (S.S.G.); (A.M.T.)
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12
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Ye Z, Wang J, Xiao Y, Luo J, Xu L, Chen Z. Global burden of benign prostatic hyperplasia in males aged 60-90 years from 1990 to 2019: results from the global burden of disease study 2019. BMC Urol 2024; 24:193. [PMID: 39237966 PMCID: PMC11376082 DOI: 10.1186/s12894-024-01582-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2024] [Accepted: 08/26/2024] [Indexed: 09/07/2024] Open
Abstract
BACKGROUND Benign prostatic hyperplasia (BPH) is a prevalent urological disease in elderly males. However, few studies have estimated the temporal and spatial distributions of the BPH burden in male adults aged 60 years and over at the global, national, and regional scales. METHODS Leveraging the Global Burden of Disease, Injuries, and Risk Factors Study, we estimated the global epidemiological trends in the prevalence, incidence, and disability-adjusted life-years (DALYs) of BPH in 204 countries and 21 regions and 5 sociodemographic index (SDI) regions in males aged 60 years and over between 1990 and 2019. The average annual percentage changes (AAPCs) in age-specific rates were estimated to quantify overall trends. We estimated the contribution of population aging and epidemiological alterations in disease burden via composition analysis. RESULTS Over the past three decades, the global prevalent cases, incident cases and DALYs of BPH have increased, ranging from 118.78 to 121.22%. The global number of prevalent BPH cases reached 79 million in people aged 60 years and older in 2019. The prevalence, incidence, and DALYs rates gradually increased, with AAPCs of 0.02, 0.02, and 0.01, respectively. Low-middle, middle, and low SDI regions experienced rapid increases in the number of prevalent cases of BPH. In 2019, China, India, and United States of America bore the largest burden of prevalent cases among people aged 60 years and over. The three regions with the highest prevalence rates of BPH were Eastern Europe, Central Latin America, and Andean Latin America. The increased prevalence was attributed to population growth (94.93%), epidemiological changes (3.45%), and aging (1.62%), globally. CONCLUSIONS BPH is a global health issue that imposes substantial economic burdens on most countries, particularly males aged 60 years and over. Effective health decisions are imperative for BPH prevention and treatment.
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Affiliation(s)
- Zhenyang Ye
- Department of Urology, West China Xiamen Hospital, Sichuan University, Xiamen, China
- Department of Urology, West China Hospital, Sichuan University, Chengdu, China
| | - Jiahao Wang
- Department of Urology, West China Hospital, Sichuan University, Chengdu, China
| | - Yunfei Xiao
- Department of Urology, West China Hospital, Sichuan University, Chengdu, China
| | - Jinyang Luo
- Department of Urology, West China Xiamen Hospital, Sichuan University, Xiamen, China
- Department of Urology, West China Hospital, Sichuan University, Chengdu, China
| | - Lijing Xu
- Department of Urology, West China Xiamen Hospital, Sichuan University, Xiamen, China
- Department of Urology, West China Hospital, Sichuan University, Chengdu, China
| | - Zaizhi Chen
- Department of Anesthesiology, The Third Hospital of Xiamen, Xiamen, China.
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Chen JL, Chen YS, Hsieh KC, Lee HM, Chen CY, Chen JH, Hung CM, Hsu CT, Huang YL, Ker CG. Clinical Nomogram Model for Pre-Operative Prediction of Microvascular Invasion of Hepatocellular Carcinoma before Hepatectomy. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:1410. [PMID: 39336451 PMCID: PMC11433876 DOI: 10.3390/medicina60091410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/23/2024] [Revised: 08/09/2024] [Accepted: 08/21/2024] [Indexed: 09/30/2024]
Abstract
Background and Objectives: Microvascular invasion (MVI) significantly impacts recurrence and survival rates after liver resection in hepatocellular carcinoma (HCC). Pre-operative prediction of MVI is crucial in determining the treatment strategy. This study aims to develop a nomogram model to predict the probability of MVI based on clinical features in HCC patients. Materials and Methods: A total of 489 patients with a pathological diagnosis of HCC were enrolled from our hospital. Those registered from 2012-2015 formed the derivation cohort, and those from 2016-2019 formed the validation cohort for pre-operative prediction of MVI. A nomogram model for prediction was created using a regression model, with risk factors derived from clinical and tumor-related features before surgery. Results: Using the nomogram model to predict the odds ratio of MVI before hepatectomy, the AFP, platelet count, GOT/GPT ratio, albumin-alkaline phosphatase ratio, ALBI score, and GNRI were identified as significant variables for predicting MVI. The Youden index scores for each risk variable were 0.287, 0.276, 0.196, 0.185, 0.115, and 0.112, respectively, for the AFP, platelet count, GOT/GPT ratio, AAR, ALBI, and GNRI. The maximum value of the total nomogram scores was 220. An increase in the number of nomogram points indicated a higher probability of MVI occurrence. The accuracy rates ranged from 55.9% to 64.4%, and precision rates ranged from 54.3% to 68.2%. Overall survival rates were 97.6%, 83.4%, and 73.9% for MVI(-) and 80.0%, 71.8%, and 41.2% for MVI(+) (p < 0.001). The prognostic effects of MVI(+) on tumor-free survival and overall survival were poor in both the derivation and validation cohorts. Conclusions: Our nomogram model, which integrates clinical factors, showed reliable calibration for predicting MVI and provides a useful tool enabling surgeons to estimate the probability of MVI before resection. Consequently, surgical strategies and post-operative care programs can be adapted to improve the prognosis of HCC patients where possible.
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Affiliation(s)
- Jen-Lung Chen
- Department of General Surgery, E-Da Hospital, I-Shou University, Kaohsiung 824, Taiwan; (J.-L.C.); (Y.-S.C.); (K.-C.H.); (H.-M.L.); (C.-Y.C.); (J.-H.C.)
| | - Yaw-Sen Chen
- Department of General Surgery, E-Da Hospital, I-Shou University, Kaohsiung 824, Taiwan; (J.-L.C.); (Y.-S.C.); (K.-C.H.); (H.-M.L.); (C.-Y.C.); (J.-H.C.)
| | - Kun-Chou Hsieh
- Department of General Surgery, E-Da Hospital, I-Shou University, Kaohsiung 824, Taiwan; (J.-L.C.); (Y.-S.C.); (K.-C.H.); (H.-M.L.); (C.-Y.C.); (J.-H.C.)
| | - Hui-Ming Lee
- Department of General Surgery, E-Da Hospital, I-Shou University, Kaohsiung 824, Taiwan; (J.-L.C.); (Y.-S.C.); (K.-C.H.); (H.-M.L.); (C.-Y.C.); (J.-H.C.)
| | - Chung-Yen Chen
- Department of General Surgery, E-Da Hospital, I-Shou University, Kaohsiung 824, Taiwan; (J.-L.C.); (Y.-S.C.); (K.-C.H.); (H.-M.L.); (C.-Y.C.); (J.-H.C.)
| | - Jian-Han Chen
- Department of General Surgery, E-Da Hospital, I-Shou University, Kaohsiung 824, Taiwan; (J.-L.C.); (Y.-S.C.); (K.-C.H.); (H.-M.L.); (C.-Y.C.); (J.-H.C.)
| | - Chao-Ming Hung
- Department of General Surgery, E-Da Cancer Hospital, I-Shou University, Kaohsiung 824, Taiwan;
| | - Chao-Tien Hsu
- Department of Pathology, E-Da Hospital, I-Shou University, Kaohsiung 824, Taiwan;
| | - Ya-Ling Huang
- Cancer Registration Center, E-Da Cancer Hospital, I-Shou University, Kaohsiung 824, Taiwan;
| | - Chen-Guo Ker
- Department of General Surgery, E-Da Hospital, I-Shou University, Kaohsiung 824, Taiwan; (J.-L.C.); (Y.-S.C.); (K.-C.H.); (H.-M.L.); (C.-Y.C.); (J.-H.C.)
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14
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Tien J, Swami N. Liver cancer: equity through disaggregation. Lancet Public Health 2024; 9:e353. [PMID: 38821681 DOI: 10.1016/s2468-2667(24)00093-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2024] [Accepted: 04/23/2024] [Indexed: 06/02/2024]
Affiliation(s)
- Joyce Tien
- UMass Chan Medical School, University of Massachusetts, Worcester, MA 01655, USA; Division of Gastroenterology and Hepatology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.
| | - Nishwant Swami
- Department of Internal Medicine, Hospital of the University of Pennsylvania, Philadelphia, PA, USA
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