Characteristics and survival of advanced untreated hepatocellular carcinoma of non-viral etiology.

IF 2 Q3 GASTROENTEROLOGY & HEPATOLOGY Indian Journal of Gastroenterology Pub Date : 2024-12-01 Epub Date: 2024-07-10 DOI:10.1007/s12664-024-01636-9

Senarath Pathiranage Nimasha Ekanayaka, Nathasha Luke, Suchintha Bandara Thilakarathne, Anuradha Dassanayake, Mahiman Bhaagya Gunetilleke, Madunil A Niriella, Rohan Chaminda Siriwardana

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Abstract

Introduction and objectives: Hepatocellular carcinoma (HCC) is an aggressive tumor and presents late. The underlying etiology of HCC is changing rapidly. HCC in Sri Lanka is unique due to its predominant non-viral etiology (nvHCC) but lacks survival data.

Method: Data was collected from patients who presented with HCC from 2011 to 2018. There were 560/568 (98.6%) nvHCC. The patients who were not candidates for tumor-specific treatment (149/560 [26.7%]) were selected. Population characteristics, demographic data, tumor characteristics, survival and factors affecting survival were analyzed.

Results: The median age was 64 years (range 30-88) and 86% (n = 129) were males. As many as 124 (83%) were cirrhotic. The overall performance score was 80%. Nearly 21/124 tumors were detected in cirrhotic screening. Tumors were single nodular in 32 (21%), up to three nodules in 28 (18%), more than three nodules in 33 (22%) and diffusely infiltrating in 56 (37%). The major venous invasions were present in 78 (52.3%). Extra-hepatic tumor spread was seen in 19 (12.7%) (lungs 13 [72.2%], bones 2 [11.1%]). The median survival of patients receiving palliative care was three months (1-43 months). Tumor size and cirrhotic status were significant predictors in univariate analysis.

Conclusion: A quarter of nvHCCs were not amenable to treatment at presentation as they had dismal survival.

Clinical trial registry number: P/126/09/2021.

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未经治疗的晚期非病毒性肝细胞癌的特征和存活率。

导言和目标：肝细胞癌（HCC）是一种侵袭性肿瘤，发病较晚。HCC 的病因正在迅速变化。斯里兰卡的 HCC 因其主要的非病毒病因（nvHCC）而独具特色，但缺乏生存数据：方法：从2011年至2018年期间的HCC患者中收集数据。其中有 560/568 例（98.6%）非病毒性 HCC。选择了不适合肿瘤特异性治疗的患者（149/560 [26.7%]）。分析了人群特征、人口统计学数据、肿瘤特征、生存率以及影响生存率的因素：中位年龄为 64 岁（30-88 岁不等），86%（129 人）为男性。肝硬化患者多达124人（83%）。总体表现评分为 80%。近 21/124 例肿瘤是在肝硬化筛查中发现的。32人（21%）的肿瘤为单发结节，28人（18%）的肿瘤为多达三个结节，33人（22%）的肿瘤为三个以上结节，56人（37%）的肿瘤为弥漫浸润。78例（52.3%）存在主要静脉侵犯。19例（12.7%）患者出现肝外肿瘤扩散（肺部13例[72.2%]，骨骼2例[11.1%]）。接受姑息治疗的患者的中位生存期为三个月（1-43 个月）。在单变量分析中，肿瘤大小和肝硬化状态是重要的预测因素：结论：四分之一的nvHCC在发病时无法接受治疗，因为他们的生存率很低：P/126/09/2021.

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Indian Journal of Gastroenterology GASTROENTEROLOGY & HEPATOLOGY-

CiteScore

3.90

自引率

10.00%

发文量

期刊介绍： The Indian Journal of Gastroenterology aims to help doctors everywhere practise better medicine and to influence the debate on gastroenterology. To achieve these aims, we publish original scientific studies, state-of -the-art special articles, reports and papers commenting on the clinical, scientific and public health factors affecting aspects of gastroenterology. We shall be delighted to receive articles for publication in all of these categories and letters commenting on the contents of the Journal or on issues of interest to our readers.