Jasirwan Com, I. Hasan, A. Sulaiman, R. Gani, Lesmana Cra, Juferdy Kurniawan, K. Kalista, S. H. Nababan
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Results: In this study, there were 282 HCC patients and the mean age was 55 ± 12.75 years. As many as 74.8% (211/282) patients were male and hepatitis B virus (HBV) was the most common etiology found (63.1%; 178/282). At the last follow up, 136 (48.2%) patients have died. Mortality rate was not significantly affected by the patient's sex, age, hepatitis etiology, cirrhotic status, nor HCC surveillance. Based on Child-Pugh (CP) classification, the odds increase progressively in CP C patients (OR 1.95; 95% CI 1.08-3.53; p=0.026). The progressive increase was also found in higher Barcelona Clinic Liver Cancer (BCLC) stage of HCC with odds ratio for C and D patients were 3.50 (95% CI 1.18-10.38; p=0.024) and 3.41 (95% CI 1.02-11.41; p=0.047) respectively. Supportive treatment was the most dominant treatment modality with odds ratio 2.17 (95% CI 1.14-4.16; p =0.019) and was found to be associated with HCC mortality rate. The median survival of all patients was 17 months from the date of diagnosis. Conclusion: Child-Pugh classification, BCLC stage and treatment modality might predict mortality in HCC patients. Other parameters need further evaluation.","PeriodicalId":91204,"journal":{"name":"Archives in cancer research","volume":"7 1","pages":""},"PeriodicalIF":0.0000,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.21767/2254-6081.100191","citationCount":"2","resultStr":"{\"title\":\"Risk Factors for Hepatocellular Carcinoma and Its Mortality Rate: A Multicenter Study in Indonesia\",\"authors\":\"Jasirwan Com, I. Hasan, A. Sulaiman, R. Gani, Lesmana Cra, Juferdy Kurniawan, K. Kalista, S. H. Nababan\",\"doi\":\"10.21767/2254-6081.100191\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Background: Hepatocellular carcinoma (HCC) is a rising cause of mortality and a significant burden. Therefore, a population-based cancer registry is an essential element to provide a baseline and comprehensive analysis of the patient's risk factors. We present a multicentre HCC registry at two hospitals in Indonesia. Methods: We performed a follow up on HCC patients admitted between January 2015 and November 2017 in Cipto Mangunkusumo National General Hospital and Dharmais Hospital, Jakarta, Indonesia. The primary outcome was the patient's death which also was the endpoint of the follow up evaluation. We conducted a multivariate analysis using logistic regression and calculated the odds ratio (OR) with 95% confidence intervals (CIs). Results: In this study, there were 282 HCC patients and the mean age was 55 ± 12.75 years. As many as 74.8% (211/282) patients were male and hepatitis B virus (HBV) was the most common etiology found (63.1%; 178/282). At the last follow up, 136 (48.2%) patients have died. Mortality rate was not significantly affected by the patient's sex, age, hepatitis etiology, cirrhotic status, nor HCC surveillance. Based on Child-Pugh (CP) classification, the odds increase progressively in CP C patients (OR 1.95; 95% CI 1.08-3.53; p=0.026). The progressive increase was also found in higher Barcelona Clinic Liver Cancer (BCLC) stage of HCC with odds ratio for C and D patients were 3.50 (95% CI 1.18-10.38; p=0.024) and 3.41 (95% CI 1.02-11.41; p=0.047) respectively. Supportive treatment was the most dominant treatment modality with odds ratio 2.17 (95% CI 1.14-4.16; p =0.019) and was found to be associated with HCC mortality rate. The median survival of all patients was 17 months from the date of diagnosis. Conclusion: Child-Pugh classification, BCLC stage and treatment modality might predict mortality in HCC patients. 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引用次数: 2
摘要
背景:肝细胞癌(HCC)是死亡率上升的原因,也是一个重要的负担。因此,以人群为基础的癌症登记是提供患者风险因素基线和全面分析的基本要素。我们在印度尼西亚的两家医院进行了多中心HCC登记。方法:我们对2015年1月至2017年11月在印度尼西亚雅加达Cipto Mangunkusumo国立综合医院和Dharmais医院入院的HCC患者进行了随访。主要结局是患者死亡,这也是随访评估的终点。我们采用logistic回归进行多变量分析,并以95%置信区间(ci)计算比值比(OR)。结果:本组HCC患者282例,平均年龄55±12.75岁。男性占74.8%(211/282),乙型肝炎病毒(HBV)是最常见的病因(63.1%;178/282)。最后一次随访时,136例(48.2%)患者死亡。死亡率不受患者性别、年龄、肝炎病因、肝硬化状态和肝细胞癌监测的显著影响。基于Child-Pugh (CP)分类,CP C患者的几率逐渐增加(OR 1.95;95% ci 1.08-3.53;p = 0.026)。在巴塞罗那临床肝癌(BCLC)分期较高的HCC中也发现了进行性增加,C和D患者的优势比为3.50 (95% CI 1.18-10.38;p=0.024)和3.41 (95% CI 1.02-11.41;分别p = 0.047)。支持治疗是最主要的治疗方式,优势比为2.17 (95% CI 1.14-4.16;p =0.019),并与HCC死亡率相关。自诊断之日起,所有患者的中位生存期为17个月。结论:Child-Pugh分型、BCLC分期及治疗方式可预测HCC患者的死亡率。其他参数需要进一步评估。
Risk Factors for Hepatocellular Carcinoma and Its Mortality Rate: A Multicenter Study in Indonesia
Background: Hepatocellular carcinoma (HCC) is a rising cause of mortality and a significant burden. Therefore, a population-based cancer registry is an essential element to provide a baseline and comprehensive analysis of the patient's risk factors. We present a multicentre HCC registry at two hospitals in Indonesia. Methods: We performed a follow up on HCC patients admitted between January 2015 and November 2017 in Cipto Mangunkusumo National General Hospital and Dharmais Hospital, Jakarta, Indonesia. The primary outcome was the patient's death which also was the endpoint of the follow up evaluation. We conducted a multivariate analysis using logistic regression and calculated the odds ratio (OR) with 95% confidence intervals (CIs). Results: In this study, there were 282 HCC patients and the mean age was 55 ± 12.75 years. As many as 74.8% (211/282) patients were male and hepatitis B virus (HBV) was the most common etiology found (63.1%; 178/282). At the last follow up, 136 (48.2%) patients have died. Mortality rate was not significantly affected by the patient's sex, age, hepatitis etiology, cirrhotic status, nor HCC surveillance. Based on Child-Pugh (CP) classification, the odds increase progressively in CP C patients (OR 1.95; 95% CI 1.08-3.53; p=0.026). The progressive increase was also found in higher Barcelona Clinic Liver Cancer (BCLC) stage of HCC with odds ratio for C and D patients were 3.50 (95% CI 1.18-10.38; p=0.024) and 3.41 (95% CI 1.02-11.41; p=0.047) respectively. Supportive treatment was the most dominant treatment modality with odds ratio 2.17 (95% CI 1.14-4.16; p =0.019) and was found to be associated with HCC mortality rate. The median survival of all patients was 17 months from the date of diagnosis. Conclusion: Child-Pugh classification, BCLC stage and treatment modality might predict mortality in HCC patients. Other parameters need further evaluation.