Prolonged survival in women with hepatocellular carcinoma: A French observational study

IF 2.6 4区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Clinics and research in hepatology and gastroenterology Pub Date : 2024-11-15 DOI:10.1016/j.clinre.2024.102498

Cécilia Busso , Jean-Charles Nault , Richard Layese , Alix Demory , Lorraine Blaise , Gisèle Nkontchou , Véronique Grando , Pierre Nahon , Nathalie Ganne-Carrié

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引用次数: 0

Abstract

Background and Aim: Less than 25 % of hepatocellular carcinoma (HCC) occurs in women, in whom prognosis could be better. Due to the lack of date in Europe, this study aims to assess survival of patients with HCC according sex in a tertiary French liver center.

Patients and Methods: Every patient diagnosed with a first diagnosis of HCC presented at our weekly multidisciplinary tumor board between 2013 and 2017 were included. Baseline characteristics of patients and tumors were compared according sex using the Mann-Whitney test for Continuous variables and the Fisher or Chi-square test for dichotomous variables. Survival analyses according sex were conducted using the Kaplan-Meier method, the log-rank test, Cox models and a propensity score.

Results: 694 patients were included, of whom 130 (18.7 %) were women. Among them, 587 (86 %) had cirrhosis, mainly compensated (Child A 62.7 %), and related to alcohol (48.7 %), HCV (27.2 %), and/or metabolic-associated fatty liver disease (25.8 %). HCC was unifocal in 54 % of cases, with a mean main nodule size of 37 mm. Curative treatment was administered in 45.4 % of cases (percutaneous ablation 93 %). Compared to men, women diagnosed with HCC were older (73 vs. 65 years, p < 0.001), were more frequently HCV-infected (40 % vs. 24 %, p = 0.0003) and presented more often with a solitary HCC (63 % vs. 52 %, p = 0.020). After a median follow-up of 57 months, overall survival was significantly longer in women both in multivariate analysis (aHR 1.39 (CI95 %: 1.07-1.81) p=0.014) and using a propensity score (HR 1.51 (1.13-2.02, p=0.005)).

Conclusion: Despite being diagnosed at an older age, women with HCC exhibit significant better overall survival.

查看原文本刊更多论文

延长肝细胞癌女性患者的生存期：一项法国观察性研究。

背景和目的：不到25%的肝细胞癌（HCC）发生在女性身上，而女性的预后可能更好。由于欧洲缺乏相关数据，本研究旨在评估法国一家三级肝病中心的HCC患者的性别存活率：纳入2013年至2017年期间每周在本院多学科肿瘤委员会首次诊断为HCC的所有患者。对连续变量采用曼-惠特尼检验，对二分变量采用费雪或卡方检验，根据性别比较患者和肿瘤的基线特征。使用卡普兰-梅耶法、对数秩检验、Cox模型和倾向评分对不同性别的患者进行生存分析：共纳入 694 例患者，其中 130 例（18.7%）为女性。其中，587 人（86%）患有肝硬化，主要是代偿性肝硬化（Child A 62.7%），与酒精（48.7%）、HCV（27.2%）和/或代谢相关性脂肪肝（25.8%）有关。54%的病例为单灶 HCC，主要结节平均大小为 37 毫米。45.4%的病例接受了根治性治疗（经皮消融占93%）。与男性相比，确诊为 HCC 的女性年龄更大（73 岁对 65 岁，p < 0.001），更常感染 HCV（40% 对 24%，p = 0.0003），更常表现为单发 HCC（63% 对 52%，p = 0.020）。在中位随访57个月后，无论是多变量分析（aHR 1.39 (CI95%: 1.07-1.81) p=0.014）还是使用倾向评分（HR 1.51 (1.13-2.02, p=0.005)），女性的总生存期都明显更长：结论：尽管女性HCC患者确诊时年龄较大，但她们的总生存率明显更高。

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

Clinics and research in hepatology and gastroenterology GASTROENTEROLOGY & HEPATOLOGY-

CiteScore

4.30

自引率

3.70%

发文量

198

审稿时长

42 days

期刊介绍： Clinics and Research in Hepatology and Gastroenterology publishes high-quality original research papers in the field of hepatology and gastroenterology. The editors put the accent on rapid communication of new research and clinical developments and so called "hot topic" issues. Following a clear Editorial line, besides original articles and case reports, each issue features editorials, commentaries and reviews. The journal encourages research and discussion between all those involved in the specialty on an international level. All articles are peer reviewed by international experts, the articles in press are online and indexed in the international databases (Current Contents, Pubmed, Scopus, Science Direct). Clinics and Research in Hepatology and Gastroenterology is a subscription journal (with optional open access), which allows you to publish your research without any cost to you (unless you proactively chose the open access option). Your article will be available to all researchers around the globe whose institution has a subscription to the journal.