Clinical characteristics of patients with hepatocellular carcinoma in Austria – is there a need for a structured screening program?

Hucke, Florian; Sieghart, Wolfgang; Schöniger–Hekele, Maximilian; Peck‐Radosavljevic, Markus; Müller, Christian

doi:10.1007/s00508-011-0033-9

Cited by 52 publications

(32 citation statements)

References 42 publications

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“…[35][36][37] HCC incidence is rising in low-endemic areas such as Europe and a 3-fold increase in mortality for the last 30 years was noted for Germany. 40,41 It might be explained by the impaired cohort effect of chronic HCV infection and the delay of HCC development in patients with HCV and HBV infection because of antiviral therapy. 39 To identify changes in the clinical characteristics of HCC patients, we compared patients from 2 consecutive 6-year periods 1998 to 2003 (n = 385) and 2004 to 2009 (n = 681).…”

Section: Discussionmentioning

confidence: 99%

Trends in Epidemiology, Treatment, and Survival of Hepatocellular Carcinoma Patients Between 1998 and 2009

Weinmann

Koch

Niederle³

et al. 2014

Journal of Clinical Gastroenterology

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Section: Discussionmentioning

confidence: 99%

Trends in Epidemiology, Treatment, and Survival of Hepatocellular Carcinoma Patients Between 1998 and 2009

Weinmann

Koch

Niederle³

et al. 2014

Journal of Clinical Gastroenterology

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“…Similar to global trends in overweight and obesity [30], the prevalence of obesity and diabetes mellitus has continuously risen over time in Austria [31,32]. Consequently, an increasing prevalence of non-alcoholic steatohepatitis (NASH) as an underlying etiological factor in HCC patients was recently reported in Austria [2]. In an English cohort, NAFLD increased over time and represented the leading liver disease associated with HCC in 2010 (35% of all cases) [28].…”

Section: Discussionmentioning

confidence: 99%

“…In Austria, the two leading underlying etiologies are alcohol abuse and chronic HCV infection [2]. The current increase in HCC incidence in Europe can possibly be attributed to the HCV infections during the 1970s and 1980s [17].…”

Section: Discussionmentioning

confidence: 99%

“…However, the diagnosis of NAFLD/NASH has become more prominent recently, but was often mislabeled as ‘cryptogenic' liver disease in the past. This has to be considered as a potential bias when reporting etiological trends in chronic liver disease [2]. …”

Section: Discussionmentioning

confidence: 99%

“…HCC usually develops in patients with underlying liver cirrhosis [2,3], who have an annual HCC incidence rate of approximately 1-8% [4]. Men are more often affected by HCC with a m/f ratio of approximately 2.4 [5].…”

Section: Introductionmentioning

confidence: 99%

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Epidemiological Trends of Hepatocellular Carcinoma in Austria

Pinter

Hucke

Zielonke

et al. 2014

Dig Dis

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Background/Aims: The heterogeneous epidemiology of hepatocellular carcinoma (HCC) with the highest incidence rates in East Asia, sub-Saharan Africa and Melanesia results from variations in the main risk factors. We investigated epidemiological trends, including incidence and mortality, of patients diagnosed with HCC over a 20-year period in Austria. Methods: Data on age-adjusted incidence rates of HCC were obtained from the Austrian National Cancer Registry, which compiles nationwide data on all newly diagnosed cancers. Data on age-adjusted mortality were obtained from the national death registry (Statistics Austria). Results: Of 24,939 patients diagnosed with hepatobiliary tumors between 1990 and 2009, 8,561 subjects had HCC (m/f ratio 75/25%; mean age 69 years). Lymph node and distant metastases were present in 7.5 and 12.2%, respectively. The age-adjusted incidence rate was significantly higher in men than women (m/f ratio 4.5/1) and markedly increased in men (4.68/5.10) but remained stable in women (1.18/1.11). Similarly, the age-adjusted mortality rate was significantly higher in men than women (m/f ratio 4.5/1), increased in men (4.02/4.98) and remained stable in women (0.92/1.0). The median overall survival was 4.5 months for men and 3.2 months for women with 1-/5-year survival rates of 33/11% and 28/10%, respectively. Conclusion: HCC is the most common hepatobiliary neoplasia in Austria and has a very poor prognosis. The age-adjusted incidence and mortality rates were higher in males, increased over time in men and remained stable in women. Extrahepatic metastases were rarely diagnosed and associated with dismal survival.

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Postembolization fever after transarterial chemoembolization is a sign of unfavorable therapeutic response in hepatocellular carcinoma patients

Peng

Teng

Hsieh

et al. 2020

Adv in Digestive Medicine

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Transarterial chemoembolization (TACE) is the standard of care for intermediate‐stage hepatocellular carcinoma (HCC) patients. The postembolization fever (PEF) is observed in 20% to 73% patients. This study aims to investigate the predictive factors of PEF and its impact on therapeutic response. From 2010 to 2015, a total of 525 HCC treatment naïve patients treated by TACE were recruited. Age, gender, etiologies of HCC, cirrhosis, tumor status, and pretherapy liver biochemistry were compared between patients with and without PEF. Predictors of PEF, complete response (CR), and progressive disease were analyzed by logistic regression. The PEF was observed in 185 patients (35.2%). The beyond up‐to‐seven, AST >2X upper limit of normal (ULN) and ALBI grade ≧2 were the independent predictors of PEF. Patients with PEF were less likely to achieve CR (18.4% vs 32.1%, P = .0017). Patients whose tumor burden beyond “up‐to‐seven” criteria with presence of tumor fever are least likely to achieve CR (aOR: 0.08, P = .022) and had higher risk for disease progression (aOR: 2.13, P = .082). PEF is related to heavier tumor burden and poorer liver reserve function. The presence of PEF is an unfavorable phenomenon correlating with poorer treatment response.

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Clinical characteristics of patients with hepatocellular carcinoma in Austria – is there a need for a structured screening program?

Abstract: Patients with HCC are still predominantly diagnosed at incurable tumor stages, despite explicit European screening guidelines existing since 9 years. The implementation of a HCC surveillance program for cirrhotic patients in Austria seems to be warranted.

Cited by 52 publications

References 42 publications

Trends in Epidemiology, Treatment, and Survival of Hepatocellular Carcinoma Patients Between 1998 and 2009

Trends in Epidemiology, Treatment, and Survival of Hepatocellular Carcinoma Patients Between 1998 and 2009

Epidemiological Trends of Hepatocellular Carcinoma in Austria

Postembolization fever after transarterial chemoembolization is a sign of unfavorable therapeutic response in hepatocellular carcinoma patients

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