Hepatocellular carcinoma in South America

Evaluation of risk factors, demographics and therapy

Jose D. Debes, Aaron J. Chan, Domingo Balderramo, Luciana Kikuchi, Esteban Gonzalez Ballerga, Jhon E. Prieto, Monica Tapias, Victor Idrovo, Milagros B. Davalos, Fernando Cairo, Fernando J. Barreyro, Sebastian Paredes, Nelia Hernandez, Karla Avendaño, Javier Diaz Ferrer, Ju Dong Yang, Enrique Carrera, Jairo A. Garcia, Angelo Z. Mattos, Bruno S. Hirsch & 3 others Pablo T. Gonçalves, Flair J. Carrilho, Lewis Rowland Roberts

Research output: Contribution to journalArticle

12 Citations (Scopus)

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.

Original languageEnglish (US)
JournalLiver International
DOIs
StateAccepted/In press - 2017

Fingerprint

South America
Hepatocellular Carcinoma
Demography
Therapeutics
Alcoholic Liver Cirrhosis
Hepatitis C
Infection
Hepatitis B
Developed Countries
Epidemiology
Retrospective Studies
Transplants
Survival
Mortality
Liver

Keywords

  • Demographics
  • Hepatocellular carcinoma
  • Risk factors
  • South America

ASJC Scopus subject areas

  • Hepatology

Cite this

Debes, J. D., Chan, A. J., Balderramo, D., Kikuchi, L., Gonzalez Ballerga, E., Prieto, J. E., ... Roberts, L. R. (Accepted/In press). Hepatocellular carcinoma in South America: Evaluation of risk factors, demographics and therapy. Liver International. https://doi.org/10.1111/liv.13502

Hepatocellular carcinoma in South America : Evaluation of risk factors, demographics and therapy. / Debes, Jose D.; Chan, Aaron J.; Balderramo, Domingo; Kikuchi, Luciana; Gonzalez Ballerga, Esteban; Prieto, Jhon E.; Tapias, Monica; Idrovo, Victor; Davalos, Milagros B.; Cairo, Fernando; Barreyro, Fernando J.; Paredes, Sebastian; Hernandez, Nelia; Avendaño, Karla; Diaz Ferrer, Javier; Yang, Ju Dong; Carrera, Enrique; Garcia, Jairo A.; Mattos, Angelo Z.; Hirsch, Bruno S.; Gonçalves, Pablo T.; Carrilho, Flair J.; Roberts, Lewis Rowland.

In: Liver International, 2017.

Research output: Contribution to journalArticle

Debes, JD, Chan, AJ, Balderramo, D, Kikuchi, L, Gonzalez Ballerga, E, Prieto, JE, Tapias, M, Idrovo, V, Davalos, MB, Cairo, F, Barreyro, FJ, Paredes, S, Hernandez, N, Avendaño, K, Diaz Ferrer, J, Yang, JD, Carrera, E, Garcia, JA, Mattos, AZ, Hirsch, BS, Gonçalves, PT, Carrilho, FJ & Roberts, LR 2017, 'Hepatocellular carcinoma in South America: Evaluation of risk factors, demographics and therapy', Liver International. https://doi.org/10.1111/liv.13502
Debes, Jose D. ; Chan, Aaron J. ; Balderramo, Domingo ; Kikuchi, Luciana ; Gonzalez Ballerga, Esteban ; Prieto, Jhon E. ; Tapias, Monica ; Idrovo, Victor ; Davalos, Milagros B. ; Cairo, Fernando ; Barreyro, Fernando J. ; Paredes, Sebastian ; Hernandez, Nelia ; Avendaño, Karla ; Diaz Ferrer, Javier ; Yang, Ju Dong ; Carrera, Enrique ; Garcia, Jairo A. ; Mattos, Angelo Z. ; Hirsch, Bruno S. ; Gonçalves, Pablo T. ; Carrilho, Flair J. ; Roberts, Lewis Rowland. / Hepatocellular carcinoma in South America : Evaluation of risk factors, demographics and therapy. In: Liver International. 2017.
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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.",
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T1 - Hepatocellular carcinoma in South America

T2 - Evaluation of risk factors, demographics and therapy

AU - Debes, Jose D.

AU - Chan, Aaron J.

AU - Balderramo, Domingo

AU - Kikuchi, Luciana

AU - Gonzalez Ballerga, Esteban

AU - Prieto, Jhon E.

AU - Tapias, Monica

AU - Idrovo, Victor

AU - Davalos, Milagros B.

AU - Cairo, Fernando

AU - Barreyro, Fernando J.

AU - Paredes, Sebastian

AU - Hernandez, Nelia

AU - Avendaño, Karla

AU - Diaz Ferrer, Javier

AU - Yang, Ju Dong

AU - Carrera, Enrique

AU - Garcia, Jairo A.

AU - Mattos, Angelo Z.

AU - Hirsch, Bruno S.

AU - Gonçalves, Pablo T.

AU - Carrilho, Flair J.

AU - Roberts, Lewis Rowland

PY - 2017

Y1 - 2017

N2 - 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.

AB - 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.

KW - Demographics

KW - Hepatocellular carcinoma

KW - Risk factors

KW - South America

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DO - 10.1111/liv.13502

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JF - Liver International

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