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Liver Int. 2018 Jan;38(1):136-143. doi: 10.1111/liv.13502. Epub 2017 Jul 18.

Hepatocellular carcinoma in South America: Evaluation of risk factors, demographics and therapy.

Author information

1
Department of Medicine, University of Minnesota, Hennepin County Medical Center, Minneapolis, MN, USA.
2
Departamento de Gastroenterologia, Hospital Privado Universitario de Córdoba, Instituto Universitario de Ciencias Biomédicas de Córdoba, Córdoba, Argentina.
3
Department of Gastroenterology, University of São Paulo School of Medicine, São Paulo, Brazil.
4
Department of Gastroenterology, Hospital Clinicas, Buenos Aires, Argentina.
5
Department of Gastroenterology, Organización Sanitas Colombia, Centro de enfermedades hepáticas y digestivas (CEHYD), Bogota, Colombia.
6
Department of Gastroenterology, Hospital Universitario Fundación Santa Fe y Organizacion Sánitas, Bogotá, Colombia.
7
Department of Gastroenterology, Hospital Nacional Edgardo Rebagliati Martins, HNERM, Lima, Peru.
8
Departamento de Gastroenterologia, Hospital El Cruce, Buenos Aires, Argentina.
9
Consejo Nacional de Investigaciones Científicas y Técnicas, Posadas, Argentina.
10
Departamento de Gastroenterologia y Hepatologia, Hospital Presidente Peron, Formosa, Argentina.
11
Departamento de Gastroenterologia y Hepatologia, Hospital de Clinicas (UdelaR), Montevideo, Uruguay.
12
Department of Gastroenterology, Mayo Clinic College of Medicine, Rochester, MN, USA.
13
Departamento de Gastroenterologia y Hepatologia, Hospital Eugenio Espejo, Quito, Ecuador.
14
Fundacion del Lili, Cali, Colombia.
15
Department of Gastroenterology, Hospital Nossa Senhora da Conceição-HNSC, Porto Alegre, Brazil.

Abstract

BACKGROUND & AIMS:

Hepatocellular carcinoma (HCC) is the second leading cause of cancer-related death worldwide. Most studies addressing the epidemiology of HCC originate from developed countries. This study reports the preliminary findings of a multinational approach to characterize HCC in South America.

METHODS:

We evaluated 1336 HCC patients seen at 14 centres in six South American countries using a retrospective study design with participating centres completing a template chart of patient characteristics. The diagnosis of HCC was made radiographically or histologically for all cases according to institutional standards. Methodology of surveillance for each centre was following AASLD or EASL recommendations.

RESULTS:

Sixty-eight percent of individuals were male with a median age of 64 years at time of diagnosis. The most common risk factor for HCC was hepatitis C infection (HCV, 48%), followed by alcoholic cirrhosis (22%), Hepatitis B infection (HBV, 14%) and NAFLD (9%). We found that among individuals with HBV-related HCC, 38% were diagnosed before age 50. The most commonly provided therapy was transarterial chemoembolization (35% of HCCs) with few individuals being considered for liver transplant (<20%). Only 47% of HCCs were diagnosed during surveillance, and there was no difference in age of diagnosis between those diagnosed incidentally vs by surveillance. Nonetheless, being diagnosed during surveillance was associated with improved overall survival (P = .01).

CONCLUSIONS:

Our study represents the largest cohort to date reporting characteristics and outcomes of HCC across South America. We found an important number of HCCs diagnosed outside of surveillance programmes, with associated increased mortality in those patients.

KEYWORDS:

South America; demographics; hepatocellular carcinoma; risk factors

PMID:
28640517
DOI:
10.1111/liv.13502
[Indexed for MEDLINE]

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