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

• Autores: 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 Javier; Paredes, Mario 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 R.
• Año de publicación: 2017
• Idioma: inglés
• Tipo de recurso: artículo
• Materia: Demographics; Hepatocellular Carcinoma; Risk Factors; South America
• Institución: Consejo Nacional de Investigaciones Científicas y Técnicas

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.
Fil: Debes, Jose D.. University of Minnesota; Estados Unidos
Fil: Chan, Aaron J.. University of Minnesota; Estados Unidos
Fil: Balderramo, Domingo. Instituto Universitario de Ciencias Biomédicas de Córdoba; Argentina
Fil: Kikuchi, Luciana. Universidade de Sao Paulo; Brasil
Fil: Gonzalez Ballerga, Esteban. Universidad de Buenos Aires. Facultad de Medicina. Hospital de Clínicas General San Martín; Argentina
Fil: Prieto, Jhon E.. Organización Sanitas; Colombia. Centro de Enfermedades Hepáticas y Digestivas; Colombia
Fil: Tapias, Monica. Organización Sanitas; Colombia. Fundación Santa Fe de Bogotá. Hospital Universitario; Colombia
Fil: Idrovo, Victor. Organización Sanitas; Colombia. Fundación Santa Fe de Bogotá. Hospital Universitario; Colombia
Fil: Davalos, Milagros B.. Hospital Nacional Edgardo Rebagliati Martins; Perú
Fil: Cairo, Fernando. Provincia de Buenos Aires. Ministerio de Salud. Hospital Alta Complejidad en Red El Cruce Dr. Néstor Carlos Kirchner Samic; Argentina
Fil: Barreyro, Fernando Javier. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Nordeste; Argentina
Fil: Paredes, Mario Sebastian. Provincia de Formosa. Ministerio de Salud. Hospital de Alta Complejidad "Pte. Juan Domingo Perón"; Argentina
Fil: Hernandez, Nelia. Universidad de la República; Uruguay
Fil: Avendaño, Karla. Universidad de la República; Uruguay
Fil: Diaz Ferrer, Javier. Hospital Nacional Edgardo Rebagliati Martins; Perú
Fil: Yang, Ju Dong. Mayo Clinic College of Medicine & Science; Estados Unidos
Fil: Carrera, Enrique. Hospital Eugenio Espejo; Ecuador
Fil: Garcia, Jairo A.. Fundación Valle del Lili; Colombia
Fil: Mattos, Angelo Z.. Hospital Nossa Senhora da Conceição; Brasil
Fil: Hirsch, Bruno S.. Hospital Nossa Senhora da Conceição; Brasil
Fil: Gonçalves, Pablo T.. Hospital Nossa Senhora da Conceição; Brasil
Fil: Carrilho, Flair J.. Universidade de Sao Paulo; Brasil
Fil: Roberts, Lewis R.. Mayo Clinic College of Medicine & Science; Estados Unidos