Outcomes of jaundice in advanced hepatocellular carcinoma - a sub-Saharan perspective.

IF 0.6 4区医学 Q4 SURGERY

South African Journal of Surgery Pub Date : 2024-05-01

P B Keshaw, M Bernon, M Emmamally, R Khan, R Segobin, D Creamer, J E J Krige, E Jonas, S Sobnach

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引用次数: 0

Abstract

Background: Jaundice is a marker of advanced disease and poor outcomes in hepatocellular carcinoma (HCC). The aim of this study was to describe and analyse the management and outcomes of jaundiced HCC patients at a large academic referral centre in sub-Saharan Africa (SSA).

Methods: Treatment-naïve adult HCC patients who presented with jaundice between 1990 and 2023 were analysed.

Results: During the inclusion period, 676 HCC patients were treated at Groote Schuur Hospital. The mean age of the 126 (18.6%) who were jaundiced was 48.8 (± 13.2) years. Eighty-nine (70.6%) were male. Ninety-four (74.6%) patients with jaundice secondary to diffuse tumour infiltration had best supportive care (BSC) only. Thirty-two had obstructive jaundice (OJ); four were excluded because of missing hospital records. In 28 of these patients, 16 underwent biliary drainage (BD) and 12 received BSC only. The mean overall survival (OS) of the 126 patients was 100.5 (± 242.3) days. The patients with diffuse tumour infiltration had an OS of 105.9 (± 273.3) days. The patients with OJ survived 86.5 (± 135.0) days. There was no significant difference in OS between the three patient groups (p = 0.941). In the OJ group, patients who underwent BD survived longer than the BSC group (117.9 ± 166.4 vs. 29.2 ± 34.7 days, p = 0.015).

Conclusion:

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晚期肝细胞癌黄疸的预后--撒哈拉以南地区的视角。

背景：黄疸是肝细胞癌（HCC）晚期和预后不良的标志。本研究旨在描述和分析撒哈拉以南非洲（SSA）一家大型学术转诊中心对黄疸型 HCC 患者的管理和治疗效果：方法：对1990年至2023年期间出现黄疸、治疗无效的成年HCC患者进行分析：结果：在纳入研究期间，有 676 名 HCC 患者在格罗特舒尔医院接受了治疗。126名（18.6%）黄疸患者的平均年龄为48.8 (± 13.2)岁。其中 89 人（70.6%）为男性。94名（74.6%）因弥漫性肿瘤浸润而继发黄疸的患者只接受了最佳支持治疗（BSC）。32人患有阻塞性黄疸（OJ），其中4人因缺少医院记录而被排除在外。其中28名患者中，16人接受了胆道引流术（BD），12人仅接受了BSC治疗。126名患者的平均总生存期（OS）为100.5（± 242.3）天。弥漫性肿瘤浸润患者的OS为105.9（± 273.3）天。OJ患者的生存期为86.5（±135.0）天。三组患者的生存期无明显差异（P = 0.941）。在OJ组中，接受BD治疗的患者存活时间长于BSC组（117.9 ± 166.4 vs. 29.2 ± 34.7天，p = 0.015）：

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来源期刊

South African Journal of Surgery 医学-外科

CiteScore

0.80

自引率

20.00%

发文量

审稿时长

>12 weeks

期刊介绍： The South African Journal of Surgery (SAJS) is a quarterly, general surgical journal. It carries research articles and letters, editorials, clinical practice and other surgical articles and personal opinion, South African health-related news, obituaries and general correspondence.