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Mai-Phan TA, Nguyen TK, Pham TN, Tran MQ, Le KL. Comparative prognostic performance of staging systems for hepatocellular carcinoma: Evidence from a Vietnamese cohort study. World J Hepatol 2025; 17:104041. [DOI: 10.4254/wjh.v17.i5.104041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2024] [Revised: 02/19/2025] [Accepted: 04/17/2025] [Indexed: 05/27/2025] Open
Abstract
BACKGROUND Hepatocellular carcinoma (HCC), the sixth most common cancer and fourth-leading cause of cancer-related mortality globally, imposes a significant burden in Vietnam due to endemic hepatitis B virus (HBV) and hepatitis C virus (HCV) infections. Accurate prognostication is crucial for optimizing treatment and outcomes. Numerous staging systems exist, including the Barcelona Clinic Liver Cancer (BCLC), Hong Kong Liver Cancer (HKLC), cancer of the liver Italian Program (CLIP), Italian Liver Cancer (ITA.LI.CA), Japan Integrated Staging (JIS), Tokyo Score, and model to estimate survival in ambulatory HCC patients (MESIAH). However, their comparative performance in Vietnamese patients remains underexplored.
AIM To compare the prognostic accuracy of seven HCC staging systems in predicting survival and identify the optimal model.
METHODS This retrospective cohort study included 987 patients with HCC diagnosed at Nhan dan Gia Dinh Hospital, Vietnam, from January 2016 to December 2023. Patients were staged using BCLC, HKLC, CLIP, ITA.LI.CA, JIS, Tokyo score, and MESIAH. Overall survival was analyzed using Kaplan-Meier methods, and prognostic performance was evaluated via the area under the receiver operating characteristic (ROC) curve, Harrell’s concordance index, and calibration plots.
RESULTS The HKLC and BCLC systems demonstrated the highest discriminatory ability, with area under the ROC curves of 0.834 and 0.830, respectively, at 12 months and 0.859 for both systems at 36 months. CLIP and ITA.LI.CA exhibited superior calibration, particularly at 36 months. The JIS system consistently showed the poorest discriminatory performance. Subgroup analyses revealed that HKLC maintained strong performance across different viral etiologies (HBV, HCV, non-B-non-C) and treatment modalities (transarterial chemoembolization, surgery, ablation).
CONCLUSION The HKLC and BCLC systems showed superior prognostic performance for Vietnamese patients with HCC, supporting HKLC adoption in clinical practice.
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Affiliation(s)
- Tuong-Anh Mai-Phan
- Department of Hepato-Pancreato-Biliary, Nhan dan Gia Dinh Hospital, Ho Chi Minh City 07000, Viet Nam
- Medicine Faculty, Nguyen Tat Thanh University, Ho Chi Minh City 700000, Vietnam
| | - Trong-Kha Nguyen
- Department of Hepato-Pancreato-Biliary, Nhan dan Gia Dinh Hospital, Ho Chi Minh City 07000, Viet Nam
| | - Tri-Nhan Pham
- Department of Hepato-Pancreato-Biliary, Nhan dan Gia Dinh Hospital, Ho Chi Minh City 07000, Viet Nam
- Department of Surgery, Pham Ngoc Thach University of Medicine, Ho Chi Minh City 07000, Viet Nam
| | - Minh-Quang Tran
- Department of Hepato-Pancreato-Biliary, Nhan dan Gia Dinh Hospital, Ho Chi Minh City 07000, Viet Nam
- Department of Surgery, Pham Ngoc Thach University of Medicine, Ho Chi Minh City 07000, Viet Nam
| | - Kim-Long Le
- Department of Hepato-Pancreato-Biliary, Nhan dan Gia Dinh Hospital, Ho Chi Minh City 07000, Viet Nam
- Department of Surgery, Pham Ngoc Thach University of Medicine, Ho Chi Minh City 07000, Viet Nam
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Duc HD, Thanh MB, Hong MB, Tien NT, Van NT, Quang BB, Dinh NC, Doan TK. Long-Term Survival and Prognostic Factors of Stereotactic Body Radiotherapy Following Transarterial Chemoembolization for Hepatocellular Carcinoma. Cancer Rep (Hoboken) 2025; 8:e70212. [PMID: 40344523 PMCID: PMC12062511 DOI: 10.1002/cnr2.70212] [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: 10/02/2024] [Revised: 03/14/2025] [Accepted: 04/11/2025] [Indexed: 05/11/2025] Open
Abstract
BACKGROUND/AIMS This study presents a detailed analysis of long-term survival and critical factors influencing the outcomes of hepatocellular carcinoma patients treated with stereotactic body radiotherapy (SBRT) and transarterial chemoembolization (TACE). Our findings provide reassurance about the potential of the combination of TACE and SBRT as an effective treatment strategy for patients with large liver tumors due to HCC. METHODS A prospective study was conducted on 42 patients with intermediate-stage hepatocellular carcinoma (HCC) at 108 Military Central Hospital between December 2018 and June 2024. Following a single session of TACE, each patient underwent SBRT 1 month later. The SBRT dose ranged from 27.5 to 48 Gy, delivered in 3-5 fractions. The patient survival analysis was conducted using the Kaplan-Meier method while examining prognostic factors influencing survival, which involved log-rank tests and Cox proportional hazards regression analysis. RESULTS Among the 42 patients (83.3% male), 34 patients (81.0%) had tumors measuring ≥ 5 cm. The median follow-up period was 32.2 months (4.5-65.1 months). The median overall survival (OS) was 32.6 months, with the respective 1-, 3-, and 5-year OS rates reported as 73.8%, 24.5%, and 19.6%. Furthermore, the median progression-free survival (PFS) was 16.6 months, with corresponding 1- and 3-year PFS rates of 71.4% and 19.0%. Factors linked to improved OS and PFS included AFP levels and treatment response based on Modified RECIST criteria. Additionally, multivariate analysis identified patient age, EQD2, and BED10 as significant predictors of better survival outcomes. CONCLUSIONS Our study provides evidence supporting the effectiveness and safety of combining TACE and SBRT as a treatment strategy for patients with large liver tumors due to HCC, instilling confidence in the future of HCC treatment. Positive prognostic factors included patient age, EQD2, and BED10.
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Affiliation(s)
- Hoang Dong Duc
- Department of Internal MedicineThai Nguyen University of Medicine and PharmacyThai NguyenVietnam
| | - Mai Binh Thanh
- Department of Gastroenterology and Hepatology108 Military Central HospitalHanoiVietnam
| | - Mai Bang Hong
- Department of Gastroenterology and Hepatology108 Military Central HospitalHanoiVietnam
| | - Nguyen Thinh Tien
- Department of Gastroenterology and Hepatology108 Military Central HospitalHanoiVietnam
| | - Nguyen Thai Van
- Department of Gastroenterology and Hepatology108 Military Central HospitalHanoiVietnam
| | - Bui Bieu Quang
- Department of Radiation Oncology and Radiosurgery108 Military Central HospitalHanoiVietnam
| | - Nguyen Chau Dinh
- Department of Radiation Oncology and Radiosurgery108 Military Central HospitalHanoiVietnam
| | - Thai Ky Doan
- Department of Gastroenterology and Hepatology108 Military Central HospitalHanoiVietnam
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Ky TD, Loan NT, Thinh NT, Binh MT. Nonadherence to oral cancer chemotherapy in hepatocellular carcinoma: prevalence and predictive factors in Vietnam. BMC Cancer 2024; 24:841. [PMID: 39009994 PMCID: PMC11247847 DOI: 10.1186/s12885-024-12601-2] [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: 08/29/2023] [Accepted: 07/03/2024] [Indexed: 07/17/2024] Open
Abstract
PURPOSE Standard oral cancer chemotherapy (OCT) or targeted therapy (OTT) has expanded the treatment methods for hepatocellular carcinoma (HCC). However, its principal nonadherence causes a reduction in efficacy. We aimed to evaluate the status of nonadherence and influencing factors among outpatient patients with HCC. PATIENTS AND METHODS In 2021, a prospective observational study was conducted on 384 patients with either old or newly diagnosed HCC treated with OTT. Nonadherence to OCT was determined using the eight-item Morisky Medication Adherence Scale, with a score < 6 points. The patients were finished with a six-month follow-up investigation by questionnaires. RESULTS 54,8% of HCC outpatients were nonadherent to OCT, with a mean Morisky score of 5.19. They dropped out of the treatment mainly because of drug side effects, such as fatigue (72.4%), hand-foot syndrome (42.7%), diarrhea (38.3%), nausea (25%), insomnia (24.7%), abdominal pain (12%), and anxiety about these adverse events (65.9%). Additionally, financial difficulties and low relative copayments were significantly correlated with the noncompliant treatment of patients (OR = 2.29, 95% CI = 1.32-3.98, P = 0.003; OR = 4.36, 95% CI = 0.95-19.93, P = 0.039, respectively). Moreover, inadequate individual information about the clinical course, the art of treatment, and medication usage instructions were suggestive barriers to adherence to treatment (OR = 1.96, 95% CI = 1.08-3.55, P = 0.024; OR = 1.86, 95% CI = 1.1-3.14, P = 0.02; OR = 2.34, 95% CI = 1.29-4.26, P = 0.004, respectively). Finally, a low level of trust in doctors was an essential factor in nonadherence (Mean of the Anderson Trust in Physician Scale scores counted 38.12 vs. 43.97, respectively for non-adherence vs. adherence, P = 0.00001). CONCLUSIONS This study suggests a high rate of primary nonadherence to standard oral targeted therapy among HCC outpatient patients because of drug side effects, patient awareness of treatment, and lack of confidence in healthcare providers. Close supervision, proper medication instructions, appropriate dosage reductions, and comprehensive patient counseling might be necessary to control nonadherence.
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Affiliation(s)
- Thai Doan Ky
- Department of Gastroenterology and Hepatology, 108 Military Central Hospital, Hanoi, Vietnam
| | - Nguyen Thi Loan
- Department of Gastroenterology and Hepatology, 108 Military Central Hospital, Hanoi, Vietnam
| | - Nguyen Tien Thinh
- Department of Gastroenterology and Hepatology, 108 Military Central Hospital, Hanoi, Vietnam
| | - Mai Thanh Binh
- Department of Gastroenterology and Hepatology, 108 Military Central Hospital, Hanoi, Vietnam.
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Kim TV, Pham TND, Do B, Dao DVB, Nguyen DX, Lee W, Gish R, Mize G, Trang A, Le A, Phan LTB, Ngo TTD, Phan HT, Nguyen BT, Tang HK, Dao DY. Low HBV knowledge is associated with low HBV vaccination uptake in general adult population despite incentivization of HBV vaccination. BMC Infect Dis 2024; 24:470. [PMID: 38702614 PMCID: PMC11067299 DOI: 10.1186/s12879-024-09326-9] [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: 12/03/2023] [Accepted: 04/15/2024] [Indexed: 05/06/2024] Open
Abstract
BACKGROUND Hepatitis B virus (HBV) vaccination in Vietnamese adults remains low and unequally distributed. We conducted a study on HBV-naïve adults living in Ho Chi Minh City, Viet Nam, to determine barriers associated with HBV vaccination uptake after removing the financial barrier by providing free coupons for HBV vaccination. METHODS After being screened for HBsAg, anti-HBs, and anti-HBc, 284 HBV-naïve study participants aged 18 and over (i.e., negative for HBsAg, anti-HBs, and anti-HBc total) were provided free 3-dose HBV vaccine coupons. Next, study participants' receipt of 1st, 2nd, and 3rd doses of HBV vaccine was documented at a pre-specified study healthcare facility, where HBV vaccines were distributed at no cost to the participants. Upon study entry, participants answered questionnaires on sociodemographics, knowledge of HBV and HBV vaccination, and related social and behavioral factors. The proportions of three doses of HBV vaccine uptake and their confidence intervals were analyzed. Associations of HBV vaccine initiation with exposures at study entry were evaluated using modified Poisson regression. RESULTS 98.9% (281 of 284) of study participants had complete data and were included in the analysis. The proportion of participants obtaining the 1st, 2nd, and 3rd doses of HBV vaccine was 11.7% (95% Confidence Interval [95% CI] 8.0-15.5%), 10.7% (95%CI 7.1-14.3%), and 8.9% (95%CI 5.6-12.2%), respectively. On the other hand, participants were more likely to initiate the 1st dose if they had adequate knowledge of transmission (adjusted relative risk [aRR] = 2.58, 95% CI 1.12-5.92), adequate knowledge of severity (aRR = 6.75, 95%CI 3.38-13.48), and annual health-checking seeking behavior (aRR = 2.04, 95%CI 1.07-3.87). CONCLUSION We documented a low HBV vaccination uptake despite incentivization. However, increased vaccine initiation was associated with better HBV knowledge and annual health check-up adherence. When considering expanding HBV vaccination to the general adult population, we should appreciate that HBV knowledge is an independent predictor of vaccine uptake.
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Affiliation(s)
- Thanh Van Kim
- Department of Epidemiology, Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Viet Nam
- Center of Excellence for Liver Disease in Viet Nam, Ross Research Building, Room 908, Johns Hopkins University School of Medicine, 720 Rutland Avenue, Baltimore, MD, 21205, USA
| | - Trang Ngoc Doan Pham
- Viet Nam Viral Hepatitis Alliance, Reston, VA, USA
- Department of Epidemiology and Biostatistics, School of Public Health, University of Illinois at Chicago, Chicago, IL, USA
| | - Brian Do
- University of California, La Jolla, San Diego, USA
| | | | - Dan Xuan Nguyen
- Department of Epidemiology, Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Viet Nam
| | - William Lee
- Viet Nam Viral Hepatitis Alliance, Reston, VA, USA
- Department of Internal Medicine, UT Southwestern Medical Center, Dallas, TX, USA
| | - Robert Gish
- Viet Nam Viral Hepatitis Alliance, Reston, VA, USA
- Hepatitis B Foundation, Doylestown, PA, USA
| | - Gary Mize
- Viet Nam Viral Hepatitis Alliance, Reston, VA, USA
| | - Amy Trang
- Viet Nam Viral Hepatitis Alliance, Reston, VA, USA
| | - Anh Le
- Viet Nam Viral Hepatitis Alliance, Reston, VA, USA
| | | | - Thi-Thuy-Dung Ngo
- Department of Epidemiology, Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Viet Nam
| | | | - Binh Tan Nguyen
- Ho Chi Minh City Department of Health, Ho Chi Minh City, Viet Nam
| | - Hong Kim Tang
- Department of Epidemiology, Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Viet Nam
| | - Doan Y Dao
- Viet Nam Viral Hepatitis Alliance, Reston, VA, USA.
- Center of Excellence for Liver Disease in Viet Nam, Ross Research Building, Room 908, Johns Hopkins University School of Medicine, 720 Rutland Avenue, Baltimore, MD, 21205, USA.
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Rabaan AA, Bello KE, Irekeola AA, Kaabi NAA, Halwani MA, Yousuf AA, Alshengeti A, Alfaraj AH, Khamis F, Al-Subaie MF, AlShehail BM, Almuthree SA, Ibraheem NY, Khalifa MH, Alfaresi M, Fares MAA, Garout M, Alsayyah A, Alshehri AA, Alqahtani AS, Alissa M. Prevalence of Hepatocellular Carcinoma in Hepatitis B Population within Southeast Asia: A Systematic Review and Meta-Analysis of 39,050 Participants. Pathogens 2023; 12:1220. [PMID: 37887736 PMCID: PMC10609743 DOI: 10.3390/pathogens12101220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 09/09/2023] [Accepted: 10/02/2023] [Indexed: 10/28/2023] Open
Abstract
BACKGROUND AND AIM Hepatocellular carcinoma (HCC) is a significant complication of hepatitis B and still poses a global public health concern. This systematic review and meta-analysis provide adequate details on the prevalence of HCC in the HBV population within Southeast Asian countries. METHOD Following the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) criteria, a thorough search for literature discussing the prevalence of HCC in the HBV population within southeast Asia was performed. Eligible studies were subjected to a meta-analysis utilising a DerSimonian and Laird approach and a random effect model. A protocol was registered with PROSPERO (CRD42023423953). RESULT Our study meticulously recovered 41 articles from seven countries in Southeast Asia, namely Cambodia, Indonesia, Malaysia, the Philippines, Singapore, Thailand, and Vietnam. A total of 39,050 HBV patients and 7479 HCC cases in southeast Asia were analysed. The pooled prevalence of HCC in HBV cases within southeast Asia was 45.8% (95% CI, 34.3-57.8%, I2 = 99.51%, p < 0.001). Singapore (62.5%, CI: 42.4-79.1) had the highest pooled prevalence of HCC in the HBV population compared to Vietnam, with the lowest estimate (22.4%, CI: 9.9-44.9). There was a drop in the pooled prevalence of HCC in HBV from 2016 until now (37.6%, CI: 19.2-60.5). CONCLUSION The findings of this review reveal a high pooled prevalence of HCC in the HBV population and therefore stir the need for routine screening, management, and surveillance.
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Affiliation(s)
- Ali A. Rabaan
- Molecular Diagnostic Laboratory, Johns Hopkins Aramco Healthcare, Dhahran 31311, Saudi Arabia
- College of Medicine, Alfaisal University, Riyadh 11533, Saudi Arabia
- Department of Public Health and Nutrition, The University of Haripur, Haripur 22610, Pakistan
| | - Kizito Eneye Bello
- Department of Microbiology, Faculty of Natural Science, Kogi State University (Prince Abubakar Audu University) Anyigba, Anyigba PMB 1008, Nigeria
- Department of Medical Microbiology and Parasitology, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia
| | - Ahmad Adebayo Irekeola
- Department of Medical Microbiology and Parasitology, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia
- Microbiology Unit, Department of Biological Sciences, College of Natural and Applied Sciences, Summit University Offa, Offa PMB 4412, Nigeria
| | - Nawal A. Al Kaabi
- College of Medicine and Health Science, Khalifa University, Abu Dhabi 127788, United Arab Emirates
- Sheikh Khalifa Medical City, Abu Dhabi Health Services Company (SEHA), Abu Dhabi 51900, United Arab Emirates
| | - Muhammad A. Halwani
- Department of Medical Microbiology, Faculty of Medicine, Al Baha University, Al Baha 4781, Saudi Arabia
| | - Amjad A. Yousuf
- Department of Medical Laboratories Technology, College of Applied Medical Sciences, Taibah University, Madinah 41411, Saudi Arabia
| | - Amer Alshengeti
- Department of Pediatrics, College of Medicine, Taibah University, Al-Madinah 41491, Saudi Arabia
- Department of Infection Prevention and Control, Prince Mohammad Bin Abdulaziz Hospital, National Guard Health Affairs, Al-Madinah 41491, Saudi Arabia
| | - Amal H. Alfaraj
- Pediatric Department, Abqaiq General Hospital, First Eastern Health Cluster, Abqaiq 33261, Saudi Arabia
| | - Faryal Khamis
- Infection Diseases Unit, Department of Internal Medicine, Royal Hospital, Muscat 1331, Oman
| | - Maha F. Al-Subaie
- College of Medicine, Alfaisal University, Riyadh 11533, Saudi Arabia
- Research Center, Dr. Sulaiman Alhabib Medical Group, Riyadh 13328, Saudi Arabia
- Department of Infectious Diseases, Dr. Sulaiman Alhabib Medical Group, Riyadh 13328, Saudi Arabia
| | - Bashayer M. AlShehail
- Pharmacy Practice Department, College of Clinical Pharmacy, Imam Abdulrahman Bin Faisal University, Dammam 31441, Saudi Arabia
| | - Souad A. Almuthree
- Department of Infectious Disease, King Abdullah Medical City, Makkah 43442, Saudi Arabia
| | - Noha Y. Ibraheem
- Department of Infectious Disease, King Abdullah Medical City, Makkah 43442, Saudi Arabia
| | - Mahassen H. Khalifa
- Department of Infectious Disease, King Abdullah Medical City, Makkah 43442, Saudi Arabia
| | - Mubarak Alfaresi
- Department of Pathology and Laboratory Medicine, Zayed Military Hospital, Abu Dhabi 3740, United Arab Emirates
- Department of Pathology, College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai 505055, United Arab Emirates
| | - Mona A. Al Fares
- Department of Internal Medicine, King Abdulaziz University Hospital, Jeddah 21589, Saudi Arabia
| | - Mohammed Garout
- Department of Community Medicine and Health Care for Pilgrims, Faculty of Medicine, Umm Al-Qura University, Makkah 21955, Saudi Arabia
| | - Ahmed Alsayyah
- Department of Pathology, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam 31441, Saudi Arabia
| | - Ahmad A. Alshehri
- Department of Clinical Laboratory Sciences, Faculty of Applied Medical Sciences, Najran University, Najran 61441, Saudi Arabia
| | - Ali S. Alqahtani
- Department of Medical Laboratory Sciences, Faculty of Applied Medical Sciences, King Khalid University, Abha 61481, Saudi Arabia
| | - Mohammed Alissa
- Department of Medical Laboratory Sciences, College of Applied Medical Sciences, Prince Sattam bin Abdulaziz University, Al-Kharj 11942, Saudi Arabia
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Le DC, Nguyen TM, Nguyen DH, Nguyen DT, Nguyen LTM. Survival Outcome and Prognostic Factors Among Patients With Hepatocellular Carcinoma: A Hospital-Based Study. Clin Med Insights Oncol 2023; 17:11795549231178171. [PMID: 37359273 PMCID: PMC10286205 DOI: 10.1177/11795549231178171] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Accepted: 05/08/2023] [Indexed: 06/28/2023] Open
Abstract
Background Hepatocellular carcinoma (HCC) is a leading cancer with very high incidence and mortality and low survival rate in Vietnam and worldwide. This study aimed to investigate the survival outcome and its prognostic factors among HCC patients. Methods This is a retrospective descriptive study on patients newly diagnosed with HCC at Hanoi Oncology Hospital, Vietnam from January 2018 to December 2020. Overall survival (OS) was calculated by the Kaplan-Meier method. Log-rank test and Cox regression were used to investigate the association among patients' OS and their diagnosis and treatment factors. Results A total of 674 patients were included. The median OS was 10.0 months. The survival rates at 6, 12, 24, and 36 months were 57.3%, 46.6%, 34.8%, and 29.7%, respectively. The initial performance status (PS), Child-Pugh score, and Barcelona Clinic Liver Cancer (BCLC) stage at the time of diagnosis are prognostic factors of HCC OS. A total of 451 (66.8%) patients have died, most of them (375 equally 83.1%) died at home, and only 76 (16.9%) died at hospital. Hepatocellular carcinoma patients living in the rural area more likely died at home than those living in the urban area (85.9% vs 74.8%, P = .007). Conclusions Hepatocellular carcinoma has a poor prognosis with low OS. Performance status, Child-Pugh score, and BCLC stage were the independent prognostic factors for the survival outcome of HCC patients. The fact that most HCC patients died at home suggested that home-based hospice care needs to be paid special attention.
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Affiliation(s)
- Dinh Cong Le
- Palliative Care Department, Hanoi Oncology Hospital, Hanoi, Vietnam
| | - Thang Minh Nguyen
- On-Demand Day Care Department, Hanoi Oncology Hospital, Hanoi, Vietnam
| | - Duong Hoang Nguyen
- On-Demand Gastrointestinal Medical Oncology Department, Hanoi Oncology Hospital, Hanoi, Vietnam
| | - Dung Thi Nguyen
- On-Demand Gastrointestinal Medical Oncology Department, Hanoi Oncology Hospital, Hanoi, Vietnam
| | - Lan Thi Mai Nguyen
- Medical Oncology II Department, Board of Directors, Hanoi Oncology Hospital, Hanoi, Vietnam
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Cam Huong NT, Van Luu N, Nam NH, Ghula S, Atieh Qarawi AT, Mai Truc PT, Trung An DN, Huy NT, Le Hoa PT. Prevalence of hepatitis B virus infection in health check-up participants: a cross-sectional study at University Medical Center, Ho Chi Minh City, Vietnam. Hosp Pract (1995) 2023. [PMID: 37262352 DOI: 10.1080/21548331.2023.2221132] [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: 11/01/2022] [Accepted: 05/31/2023] [Indexed: 06/03/2023]
Abstract
OBJECTIVES Vietnam is one of the countries in highly endemic areas of hepatitis B virus (HBV) infection in the world. Our study aims to determine the prevalence of HBV infection among different age groups of workers who had been included for annual general health checkups. METHODS This cross-sectional study was conducted at the Health Screening Department, University Medical Center at Ho Chi Minh City, Vietnam, using anonymous data from employees who had health checkups from June 2017 to June 2018. RESULTS A total of 5727 subjects were included, with an overall HBV prevalence of 9.0%. The prevalence of HBV infection was significantly higher in men and lowest in the age groups of 18-30. In multivariable analysis, the variables that were independently associated with HBV infection were male gender (Odd ratio (OR), 2.03; 95% confidence interval (CI), 1.58-2.60; p < 0.001), older than 30 years old (age group of 31-40: OR 1.7; 95% CI, 1.33-2.18; p < 0.001; of 41-50, OR 1.82; 95% CI, 1.37-2.43; p < 0.001); high total cholesterol (OR, 0.77; 95% CI, 0.64-0.94; p = 0.011), high triglyceride (OR, 0.53; 95% CI, 0.42-0.65; p < 0.001), and having significant fibrosis (OR, 2.7; 95% CI 1.85-3,95; p < 0.001). CONCLUSIONS The prevalence of HBV infection among employees on health assessments is still high (9%), even in the age group under 30 (7%). Male, age group older than 30, and significant liver fibrosis were the factors related to HBV infection. High cholesterol and level triglyceride were protective factors against HBV infection.
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Affiliation(s)
- Nguyen Thi Cam Huong
- Infectious Diseases Department, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
- Outpatient Department, University Medical Center, Ho Chi Minh City, Vietnam
| | - Nguyen Van Luu
- Infectious Diseases Department, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Nguyen Hai Nam
- Division of Hepato-Biliary-Pancreatic Surgery and Transplantation, Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
- Online Research Club , Nagasaki, Japan, Http://Www.Onlineresearchclub.org
| | - Suhaib Ghula
- Online Research Club , Nagasaki, Japan, Http://Www.Onlineresearchclub.org
- Medical School, University of Buckingham, Buckingham, UK
| | - Ahmad Taysir Atieh Qarawi
- Online Research Club , Nagasaki, Japan, Http://Www.Onlineresearchclub.org
- Lower Westchester Medical Associate, New York, P.C. Mount Vernon, USA
| | - Pham Thi Mai Truc
- Online Research Club , Nagasaki, Japan, Http://Www.Onlineresearchclub.org
- Imaging Diagnostic Department, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Dang Nguyen Trung An
- Imaging Diagnostic Department, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
- Health Screening Department, University Medical Center, Ho Chi Minh City, Vietnam
| | - Nguyen Tien Huy
- Online Research Club , Nagasaki, Japan, Http://Www.Onlineresearchclub.org
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
| | - Pham Thi Le Hoa
- Infectious Diseases Department, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
- Outpatient Department, University Medical Center, Ho Chi Minh City, Vietnam
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Huy DQ, Chung NV, Dong DT. Value of Some Scoring Systems for the Prognosis of Rebleeding and In-Hospital Mortality in Liver Cirrhosis with Acute Variceal Bleeding. GASTROENTEROLOGY INSIGHTS 2023; 14:144-155. [DOI: 10.3390/gastroent14020011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2025] Open
Abstract
Background: Upper gastrointestinal (GI) hemorrhage, caused by acute esophageal variceal bleeding, is a common complication and a leading cause of death in patients with cirrhosis. Therefore, predicting the risk in order to employ an active management to prevent rebleeding and death is crucial. Currently, there are many prognostic scoring systems that have been proposed, but research is needed to find a valid score which can be applied in clinical practice in each country and population. Aims: To compare the value of ALBI (Albumin-Bilirubin), PALBI (Platelet Albumin-Bilirubin), AIMS65, model for end-stage liver disease (MELD), and Child–Pugh scores (CPS) approaches in predicting early rebleeding and in-hospital mortality of acute variceal bleeding in patients with cirrhosis. Subjects and methods: We performed a cross-sectional descriptive study on cirrhotic patients with acute variceal bleeding who were being treated at the Department of Gastroenterology, Intensive care unit—Military Hospital 103 and the Institute for Treatment of Digestive Diseases—108 Military Central Hospital from September 2020 to May 2022. We calculated ALBI, PALBI, AIMS65, MELD, Child–Pugh values and compared them with the rates of early rebleeding and in-hospital mortality. Then, determined and compared the prognostic value through an analysis of the area under the curve (AUC). Results: 222 patients with acute esophageal variceal bleeding were eligible for inclusion in the study. The rates of rebleeding and in-hospital mortality were 9.0% and 6.8%, respectively. Regarding the prognosis of early rebleeding, the ALBI and PALBI scores have good prognostic value (AUROC 0.74; 95% CI: 0.63–0.85 and AUROC 0.7; 95% CI: 0.59–0.81; p = 0.004, respectively), while the Child–Pugh, MELD, AIMS65 scores have little prognostic value, with AUROC < 0.70. Regarding prognosis of in-hospital mortality: the ALBI, PALBI, MELD and AIMS65 all have good value in predicting in-hospital mortality, with AUROC of 0.81 (95% CI: 0.68–0.93, respectively; p < 0.001); 0.8 (95% CI: 0.69–0.91; p <0.001); 0.83 (95% CI: 0.72–0.93; p < 0.001); and 0.82 (95% CI: 0.76–0.87, p < 0.001), respectively. While Child–Pugh score only has medium prognostic value, with AUROC 0.79 (95% CI: 0.66–0.92; p < 0.05). However, there was no significant difference between these prognostic scoring systems. Conclusion: the ALBI, PALBI, MELD and AIMS65 scores all had similar good value in predicting in-hospital mortality, but with early rebleeding prognosis, only ALBI and PALBI had good value. CPS does not show prognostic value like other scores, both in predicting early rebleeding and in-hospital mortality.
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Affiliation(s)
- Duong Quang Huy
- Department of Gastroenterology, 103 Military Hospital, Vietnam Military Medical University, Hanoi 100000, Vietnam
| | - Nguyen Van Chung
- Department of Gastroenterology, 103 Military Hospital, Vietnam Military Medical University, Hanoi 100000, Vietnam
| | - Dinh Tien Dong
- Department of Gastroenterology, 103 Military Hospital, Vietnam Military Medical University, Hanoi 100000, Vietnam
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Comparisons of Viral Etiology and Outcomes of Hepatocellular Carcinoma Undergoing Liver Resection between Taiwan and Vietnam. Viruses 2022; 14:v14112571. [PMID: 36423180 PMCID: PMC9695296 DOI: 10.3390/v14112571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 11/17/2022] [Accepted: 11/19/2022] [Indexed: 11/22/2022] Open
Abstract
Epidemiologic data have suggested that etiologic variations of hepatocellular carcinoma (HCC) exist in different geographic areas, and might be associated with different outcomes. We compared the viral etiology, clinicopathological characteristics and surgical outcomes between 706 Taiwanese and 1704 Vietnamese patients with HCC undergoing liver resection. Vietnamese patients had a significantly higher ratio of hepatitis B virus (HBV) (p < 0.001) and a lower ratio of hepatitis C virus (HCV) (p < 0.001) and non-B non-C than Taiwanese patients. Among patients with HBV or non-B non-C, the mean age was younger in Vietnam than in Taiwan (p < 0.001, p = 0.001, respectively). The HCC patients in Vietnam had significantly higher serum alpha-fetoprotein (AFP) levels (p < 0.001), larger tumors (p < 0.001), and a higher ratio of macrovascular invasion (p < 0.001) and extrahepatic metastasis (p < 0.001), compared to those in Taiwan. Patients treated in Vietnam had a higher tumor recurrent rate (p < 0.001), but no difference in overall survival was found between both groups. In subgroup analysis, the recurrent rate of HCC was the highest in patients with dual HBV/HCV, followed by HCV or HBV, and non-B non-C (p < 0.001). In conclusion, although the viral etiology and clinicopathological characteristics of HCC differed, postoperative overall survival was comparable between patients in Taiwan and Vietnam.
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10
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Thi Cam Huong N, Trung NQ, Luong BA, Tram DB, Vu HA, Bui HH, Pham Thi Le H. Mutations in the HBV PreS/S gene related to hepatocellular carcinoma in Vietnamese chronic HBV-infected patients. PLoS One 2022; 17:e0266134. [PMID: 35390033 PMCID: PMC8989215 DOI: 10.1371/journal.pone.0266134] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2021] [Accepted: 03/15/2022] [Indexed: 12/23/2022] Open
Abstract
Background Chronic hepatitis B virus (CHB) infection is a major health problem and leading cause of hepatocellular carcinoma (HCC) worldwide. Several point and deletion mutations on the PreS/S gene have been intensively considered associated with HCC. This study aimed to describe the characteristics of HBV PreS/S mutations in Vietnamese CHB-infected patients and their association with HCC. Methods This cross-sectional study was conducted from 02/2020 to 03/2021, recruited Vietnamese CHB-infected patients with HBV-DNA >3 log10-copies/mL and successful PreS/S gene sequencing. Mutations were detected by direct Sanger sequencing. Results 247 CHB-infected patients were recruited, characterized by 68.8% males, 54.7% HBV genotype B, 57.5% HBeAg positive, 23.1% fibrosis score ≥F3 and 19.8% HCC. 61.8% amino acid replacements were detected throughout the PreS1/PreS2/S genes. The most common point-mutations included N/H51Y/T/S/Q/P (30.4%), V68T/S/I (44.9%), T/N87S/T/P (46.2%) on PreS1 gene; T125S/N/P (30.8%), I150T (42.5%) on PreS2 gene; S53L (37.7%), A184V/G (39.3%), S210K/N/R/S (39.3%) on S gene. The rates of case(s) with any point-mutation on the Major Hydrophylic Region (MHR) and the "a" determinant region were 63.6% and 39.7%, respectively. Most of S point-mutations were presented with low rates such as T47A/E/V/K (9.3%), P120S/T (8.5%), G145R (2%). On multivariable analysis, males (OR = 4.51, 95%CI 1.78–11.4, p = 0.001), age≥40 (OR = 5.5, 95%CI 2.06–14.68, p = 0.001), W4P/R/Y on PreS1 (OR = 11.56, 95%CI 1.99–67.05, p = 0.006) and 4 S point-mutations as: T47A/E/V/K (OR = 3.67, 95%CI 1.19–11.29, p = 0.023), P120S/T (OR = 3.38, 95%CI 1.09–10.49, p = 0.035), S174N (OR = 29.73, 95%CI 2.12–417.07, p = 0.012), P203R (OR = 8.45, 95%CI 1.43–50.06, p = 0.019) were associated with HCC. Conclusions We detected 61% amino acid changes on PreS/S regions in Vietnamese CHB patients. One point-mutation at amino acid 4 on PreS1 gene and 4 point-mutations at amino acids 47, 120, 174, and 203 on S gene were associated with HCC. Further investigations are recommended to further clarify the relationship and interaction between mutations in HBV genome and HCC progression.
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Affiliation(s)
- Nguyen Thi Cam Huong
- Department of Infectious Diseases, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
- Department of Gastroenterology, University Medical Center, Ho Chi Minh City, Vietnam
- * E-mail:
| | - Nguyen Quang Trung
- Department of Infectious Diseases, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
- Department of Gastroenterology, University Medical Center, Ho Chi Minh City, Vietnam
| | - Bac An Luong
- Center for Molecular Biomedicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Duong Bich Tram
- Center for Molecular Biomedicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Hoang Anh Vu
- Center for Molecular Biomedicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Hoang Huu Bui
- Department of Gastroenterology, University Medical Center, Ho Chi Minh City, Vietnam
| | - Hoa Pham Thi Le
- Department of Infectious Diseases, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
- Department of Gastroenterology, University Medical Center, Ho Chi Minh City, Vietnam
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Nguyen T, Pham T, Phan L, Mize G, Trang A, Dao D, Le A, Gish R, Lee WM, Do D, Tang HK, Phan HT, Nguyen BT, Dao DY. Progressive Scale-up of HBV AND HCV Testing for Hepatitis Elimination in Vietnam. Clin Liver Dis (Hoboken) 2021; 18:261-265. [PMID: 34976369 PMCID: PMC8688896 DOI: 10.1002/cld.1186] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 10/16/2021] [Accepted: 10/24/2021] [Indexed: 02/04/2023] Open
Abstract
Content available: Audio Recording.
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Affiliation(s)
- Tran Nguyen
- Vietnam Viral Hepatitis AllianceRestonVA,UT Southwestern Medical CenterDallasTX
| | - Trang Pham
- Vietnam Viral Hepatitis AllianceRestonVA,University of Illinois at ChicagoChicagoIL
| | - Loc Phan
- Vietnam Viral Hepatitis AllianceRestonVA
| | - Gary Mize
- Vietnam Viral Hepatitis AllianceRestonVA
| | - Amy Trang
- Vietnam Viral Hepatitis AllianceRestonVA
| | - Diem Dao
- Vietnam Viral Hepatitis AllianceRestonVA
| | - Anh Le
- Vietnam Viral Hepatitis AllianceRestonVA
| | | | - William M. Lee
- Vietnam Viral Hepatitis AllianceRestonVA,UT Southwestern Medical CenterDallasTX
| | - Dung Do
- Pham Ngoc Thach University of MedicineHo Chi Minh CityVietnam
| | - Hong K. Tang
- Pham Ngoc Thach University of MedicineHo Chi Minh CityVietnam
| | - Hai T. Phan
- Medical Medical CenterHo Chi Minh CityVietnam
| | - Binh T. Nguyen
- Ho Chi Minh City Department of HealthHo Chi Minh CityVietnam
| | - Doan Y Dao
- Vietnam Viral Hepatitis AllianceRestonVA,Center of Excellence for Liver Disease in VietnamJohns Hopkins University School of MedicineBaltimoreMD
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12
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Nguyen TTH, Nguyen VH, Nguyen VH, Nguyen TL, Le VQ. Role of Baseline Albumin-Bilirubin Grade on Predict Overall Survival Among Sorafenib-Treated Patients With Hepatocellular Carcinoma in Vietnam. Cancer Control 2020; 26:1073274819865269. [PMID: 31364390 PMCID: PMC6669852 DOI: 10.1177/1073274819865269] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Introduction: Albumin-bilirubin (ALBI) grade has been recently used in evaluation of liver function and prognosis of patients with hepatocellular carcinoma (HCC). However, in Vietnam, the utility of ALBI grade in clinical setting has not been adequately investigated. Methods: This is a retrospective study of 110 patients with HCC treated with sorafenib from January 2010 to November 2018 at 2 tertiary hospitals in Vietnam. Prognostic value of ALBI grade was evaluated by Kaplan-Meier survival analysis and Cox proportional regression model. Results: Results showed that the majority of ALBI grade 1 were Child-Pugh level A (97.5%); ALBI grade 2 was seen in all Child-Pugh score groups of 5, 6, 7, ≥8, whereas ALBI grade 3 was mostly reported in Child-Pugh score ≥8 group (83.3%). Compared with ALBI grade 3, ALBI grade 1 reduced 66.4% risk of death (hazards ratio [HR] = 0.336, 95% confidence interval [CI]: 0.115-0.981; P = .046). Compared with ALBI grade 3, ALBI grade 2 reduced 67.3% risk of death (HR = 0.327, 95% CI: 0.122-0.875; P = .026). Albumin-bilirubin grade was an independent predictor of survival outcome. Conclusion: Baseline ALBI grade is a simple and objective approach in assessing liver functions of patients with HCC. Baseline ALBI grade is an independent predictor of survival in patients treated with sorafenib.
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Affiliation(s)
- Thi Thu Huong Nguyen
- 1 Department of Oncology, Hanoi Medical University, Hanoi, Vietnam.,2 Department of General Medical Oncology, Vietnam National Cancer Institute, Hanoi, Vietnam
| | - Van Hieu Nguyen
- 1 Department of Oncology, Hanoi Medical University, Hanoi, Vietnam
| | - Van Hung Nguyen
- 1 Department of Oncology, Hanoi Medical University, Hanoi, Vietnam
| | | | - Van Quang Le
- 1 Department of Oncology, Hanoi Medical University, Hanoi, Vietnam.,2 Department of General Medical Oncology, Vietnam National Cancer Institute, Hanoi, Vietnam
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Pham BV, Phan HH, Ngo LL, Nguyen HTT, Le KV, Dinh TC, Bac ND. A Rare Colonic Metastasis Case from Hepatocellular Carcinoma. Open Access Maced J Med Sci 2019; 7:4368-4371. [PMID: 32215096 PMCID: PMC7084010 DOI: 10.3889/oamjms.2019.837] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Revised: 11/20/2019] [Accepted: 11/21/2019] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Hepatocellularcarcinoma (HCC) metastasis include intrahepatic and extrahepatic metastasis. Similar to intrahepatic metastasis, extrahepatic metastases are not unusual in cases with HCC. However, colonic metastasis is infrequent. CASE REPORT We describe a clinical case, he was diagnosed with HCC a year ago, treated with TACE (transarterialchemoembolisation), re-examined with abdominal pain and defecation disorder. The tests such as CT scan, colorectal endoscopy, fine needle aspiration (FNA) revealed secondary metastatic lesion of HCC in sigmoid colon. This is the first gastrointestinal (GI) tract metastatic we have encountered. CONCLUSION HCC metastases of the colon are rare, especially cases of hematogenous spread. The prognosis of these patients is often very critical. Indications for surgical removal of the lesion may be used if the general situation of patient is acceptable.
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Affiliation(s)
| | | | - Lam Le Ngo
- Vietnam National Cancer Hospital, Hanoi, Vietnam
| | | | - Ky Van Le
- Vietnam National Cancer Hospital, Hanoi, Vietnam
| | - Thien Chu Dinh
- Institute for Research and Development, Duy Tan University, 03 Quang Trung, Danang, Vietnam
| | - Nguyen Duy Bac
- Vietnam Military Medical University (VMMU), Hanoi, Vietnam
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Phase I Clinical Trial Using Autologous Ex Vivo Expanded NK Cells and Cytotoxic T Lymphocytes for Cancer Treatment in Vietnam. Int J Mol Sci 2019; 20:ijms20133166. [PMID: 31261712 PMCID: PMC6651639 DOI: 10.3390/ijms20133166] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Revised: 06/22/2019] [Accepted: 06/24/2019] [Indexed: 12/14/2022] Open
Abstract
(1) Background: Immune cell therapy recently attracted enormous attention among scientists as a cancer treatment, but, so far, it has been poorly studied and applied in Vietnam. The aim of this study was to assess the safety of autologous immune cell therapy for treating lung, liver, and colon cancers-three prevalent cancers in Vietnam. (2) Method: This was an open-label, single-group clinical trial that included 10 patients with confirmed diagnosis of colon, liver, or lung cancer, conducted between March 2016 and December 2017. (3) Results: After 20-21 days of culture, the average number of cytotoxic T lymphocytes (CTLs) increased 488.5-fold and the average cell viability was 96.3%. The average number of natural killer cells (NKs) increased 542.5-fold, with an average viability of 95%. Most patients exhibited improved quality of life, with the majority of patients presenting a score of 1 to 2 in the Eastern Cooperative Oncology Group (ECOG) performance status (ECOG/PS) scale, a decrease in symptoms on fatigue scales, and an increase in the mean survival time to 18.7 months at the end of the study. (4) Conclusion: This method of immune cell expansion met the requirements for clinical applications in cancer treatment and demonstrated the safety of this therapy for the cancer patients in Vietnam.
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Svobodova S, Karlikova M, Topolcan O, Pecen L, Pestova M, Kott O, Treska V, Slouka D, Kucera R. PIVKA-II as a Potential New Biomarker for Hepatocellular Carcinoma - A Pilot Study. In Vivo 2019; 32:1551-1554. [PMID: 30348715 DOI: 10.21873/invivo.11413] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Revised: 09/18/2018] [Accepted: 09/21/2018] [Indexed: 02/07/2023]
Abstract
AIM The aim of this study was to evaluate the clinical contribution of protein induced by vitamin K absence (PIVKA-II) for hepatocellular carcinoma (HCC) diagnostics and compare it with alpha-foetoprotein (AFP), a routinely used tumour marker. MATERIALS AND METHODS A total of 332 participants were enrolled in this study: 64 with HCC, 48 with liver metastases of colorectal cancer origin, 42 with liver cirrhosis and 178 healthy individuals. Serum levels of PIVKA-II were measured using the chemiluminescent assay of the Architect 1000i System (Abbott, USA) and AFP levels using the chemiluminescent assay by DxI 800 (Beckman Coulter, USA). RESULTS PIVKA-II achieved better clinical sensitivity than AFP and the difference in this sensitivity was statistically significant. PIVKA-II achieved the best sensitivity (96.9%) in distinguishing between the HCC and control groups with the proposed cut-off value of 60 mAU/ml. CONCLUSION Our recommendation is for addition of PIVKA-II to the routine panel of HCC tumour markers.
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Affiliation(s)
- Sarka Svobodova
- Department of Immunochemistry, University Hospital and Faculty of Medicine in Pilsen, Charles University, Czech Republic.,Third Internal Medicine Department and First Medical Faculty, Charles University, Prague, Czech Republic
| | - Marie Karlikova
- Department of Immunochemistry, University Hospital and Faculty of Medicine in Pilsen, Charles University, Czech Republic
| | - Ondrej Topolcan
- Department of Immunochemistry, University Hospital and Faculty of Medicine in Pilsen, Charles University, Czech Republic
| | - Ladislav Pecen
- Department of Immunochemistry, University Hospital and Faculty of Medicine in Pilsen, Charles University, Czech Republic
| | - Martina Pestova
- Department of Immunochemistry, University Hospital and Faculty of Medicine in Pilsen, Charles University, Czech Republic
| | - Otto Kott
- Faculty of Health Care Studies, University of West Bohemia, Pilsen, Czech Republic
| | - Vladislav Treska
- Department of Surgery, University Hospital and Faculty of Medicine in Pilsen, Charles University, Czech Republic
| | - David Slouka
- Department of Immunochemistry, University Hospital and Faculty of Medicine in Pilsen, Charles University, Czech Republic
| | - Radek Kucera
- Department of Immunochemistry, University Hospital and Faculty of Medicine in Pilsen, Charles University, Czech Republic
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