Hepatocellular Carcinoma in a Tertiary Referral Hospital in Indonesia: Lack of Improvement of One-Year Survival Rates between 1998-1999 and 2013-2014

Loho, Imelda Maria; Hasan, Irsan; Lesmana, Cosmas Rinaldi Adithya; Dewiasty, Esthika; Gani, Rino Alvani

doi:10.7314/apjcp.2016.17.4.2165

Cited by 21 publications

(21 citation statements)

References 23 publications

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“…Hepatocellular carcinoma (HCC) is the sixth most common cancer and leads to the third cancer-related death worldwide (El-Serag, 2011), thus remaining a significant health problem especially in Asian and sub-Saharan African countries (Pourhoseingholi and Zali, 2010;Wang et al, 2015;Loho et al, 2016;Kaneko et al, 2017;Chuncharunee and Siramolpiwat, 2017;Tunissiolli et al, 2017). In Thailand, HCC is the most common cancer in men and the third most common cancer in women (Somboon et al, 2014).…”

Section: Introductionmentioning

confidence: 99%

Risk Factors and Prognosis of Spontaneously Ruptured Hepatocellular Carcinoma in Thailand

Kerdsuknirun

Vilaichone

2018

Asian Pac J Cancer Prev

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Objective: Hepatocellular carcinoma (HCC) is the fatal cancer worldwide. Spontaneously Rupture remains important complication of HCC. The incidence of spontaneous HCC rupture was high in ASEAN but limited studies were reported. The aim of this study was to evaluate predictors and overall survival of ruptured HCC in tertiary care center in Thailand. Methods: We conducted a retrospective cohort study of HCC patients aged ≥15 years old during January 2012-January 2016 and followed up through June 2016 at Thammasat University Hospital, Thailand. All clinical information, laboratory and radiologic findings were collected from reviewing computer data base of medical records. Results: 333 patients had completely retrievable information. Of which, 51patients (15.3%) had spontaneous ruptured HCC. Clinical symptoms with abdominal discomfort and anemic symptoms were significantly higher in ruptured than non-ruptured HCC groups. (76.47% vs.39.36%: p<0.001, 13.73vs.0.71%, p<0.001). Furthermore, size of tumors, presences of metastasis and serum AFP>200 ng/mL were significantly higher in ruptured than non-ruptured HCC groups (10.29cm. vs. 6.47cm. p<0.001, 17.65% vs. 8.16%, p=0.034, 60.78% vs. 36.88%, p=0.001, respectively). In multivariate analysis, age, abdominal discomfort, anemic symptoms, Child-Pugh score>6 were independent risk factors of HCC rupture (OR=0.96, 95%CI=0.93-0.99, p=0.02; OR=3.47, 95%CI=1.26-9.6, p=0.016; OR=54.51, 95%CI=7.09-418.89, p<0.001; OR=2.62, 95%CI=1.09-6.31, p=0.031, respectively). 1-year and 2-year survival rates of ruptured HCC were 66.9% and 44.6% respectively. Conclusions: Age, abdominal discomfort, anemic symptoms and Child-Pugh score>6 might be predictive factors of spontaneous ruptured HCC. Ruptures of HCC remained a fatal disease with poor survival rate in Thailand. Appropriate treatment in early stage could be effective tool to improve the treatment outcomes

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Section: Introductionmentioning

confidence: 99%

Risk Factors and Prognosis of Spontaneously Ruptured Hepatocellular Carcinoma in Thailand

Kerdsuknirun

Vilaichone

2018

Asian Pac J Cancer Prev

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“…In a large-scale retrospective cohort study of 1257 Japanese patients, both quantity (defined by low SMI) and quality (determined by low MA) of muscle were identified as significant predictors of HCC survival [2]. In Japan, where a national surveillance program has been applied to the high-risk population since 1980, 62% of HCC cases are diagnosed at BCLC stage A, and the median survival time for HCC patients is 47.2 months, which is considered the best in the world [6,11]. In Japan, HCC is mostly caused by hepatitis C virus infection and is more prevalent in the older population (mean age, 68 years); this may affect sarcopenia status, as this term also refers to the age-related decline in muscle mass and function [2].…”

Section: Discussionmentioning

confidence: 99%

Sarcopenia and intramuscular fat deposition are associated with poor survival in Indonesian patients with hepatocellular carcinoma: a retrospective study

Mardian

Yano²,

Ratnasari

et al. 2019

Preprint

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Background A large-scale Japanese study showed that low skeletal muscle index (SMI) and intramuscular fat (IMF) deposition are associated with hepatocellular carcinoma (HCC) survival. Here, we evaluated the effects of SMI and IMF on the survival of Indonesian HCC patients, whose characteristics differ from those of Japanese patients.Methods SMI and mean muscle attenuation (MA) were evaluated using computed tomography images of the third lumbar vertebra (L3) in a prospective cohort of 100 Indonesian HCC patients. Clinical, laboratory and body composition data were analysed using the Kaplan–Meier method and Cox regression model to investigate which factors are associated with prognosis.Results Of 100 patients, 31 were diagnosed with sarcopenia (L3 SMI value ≤36.2 cm 2 /m 2 for men and ≤29.6 cm 2 /m 2 for women), and 65 had IMF deposition (MA value ≤44.4 HU for men and ≤39.3 HU for women). These groups had shorter median survival than the reference groups (both P <0.0001). In multivariable analysis, sarcopenia (hazard ratio [HR], 1.921; P = 0.016), IMF deposition (HR, 3.580; P <0.001), Barcelona Clinic Liver Cancer (BCLC) stages C and D (HR: 2.396, P <0.01 and HR: 6.131, P <0.01, respectively), Japan Integrated Staging (JIS) score 4 (HR: 2.067, P = 0.020), and male gender (HR: 3.211, P <0.001) were independently associated with mortality.Conclusion Sarcopenia and IMF deposition showed superior value in combination with BCLC stage and JIS score for predicting the survival of Indonesian HCC patients. Increased awareness and strategies to prevent or reverse these factors might improve patient outcomes. (Electric word counts: 249)

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“…Hepatocellular carcinoma (HCC) is the sixth most common cancer and leads to major cancer related death worldwide (El-Serag, 2011;Kaneko et al, 2017;Chuncharunee and Siramolpiwat, 2017;Loho et al, 2016;Intaraprasong et al, 2016 ). In Thailand, HCC is the most common cancer in men and the third most common cancer in women (Somboon et al, 2014).…”

Section: Introductionmentioning

confidence: 99%

“…The patients with HCC mostly have underlying chronic liver disease including liver cirrhosis (Bosch et al, 2005). The incidence of HCC is increasing in several developing countries, including Thailand and its dominant causes were related to hepatitis B virus, hepatitis C virus and alcoholic cirrhosis (Liang et al, 2013;Chunlertrith et al, 2000;Loho et al, 2016;Wiangnon et al, 2012;Wanich et al, 2016).…”

Section: Introductionmentioning

confidence: 99%

Clinical Outcome and Predictive Factors of Variceal Bleeding in Patients with Hepatocellular Carcinoma in Thailand

Kerdsuknirun

Vilaichone

2018

Asian Pac J Cancer Prev

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Objective:Hepatocellular carcinoma (HCC) is common cancer in ASEAN. Variceal bleeding (VB) is considered to be fatal complication of cirrhosis with HCC. However, limited studies were reported in ASEAN. Aim of this study was to evaluate overall survival rate and predictors of VB in HCC patients.Methods:We conducted a retrospective cohort study of HCC patients aged ≥15 years between January 2012-January 2016 and follow up through June 2016 at Thammasat University Hospital, Thailand. Clinical information and radiologic findings were collected from reviewing computer database of medical records.Results:333 patients had completely retrievable information. Of which, 27 patients (8.1%) had documented with VB. Clinical presentations with weight loss and jaundice were higher in VB than non-VB groups (40.74% vs. 34.64%, p=0.525 and 7.41% vs. 2.29%, p=0.116) but the differences were not significant. The most common causes of cirrhosis in HCC patients with VB were chronic HBV infection (55.56%). In multivariate analysis; presence of ascites, Child-Pugh score>6, presence of varices were independent risk factors of having VB in HCC patients (OR=7.59, 95%CI=1.13-50.88, p=0.037; OR=5.07, 95%CI=1.08-23.76, p=0.039; OR=23.51, 95%CI=4.71-117.35, p<0.001, respectively). In HCC patients with VB, 1-year and 2.5-year survival rates were 56.6% and 28.3%.Conclusions:HCC patients with ascites, Child-Pugh score>6 and presence of varices might be important predictive factors of VB. Having VB were greatly impact to the survival rate of HCC patients. Clinical suspicion and regular surveillance of VB in HCC patients at risk could improve treatment outcomes.

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Hepatocellular Carcinoma in a Tertiary Referral Hospital in Indonesia: Lack of Improvement of One-Year Survival Rates between 1998-1999 and 2013-2014

Cited by 21 publications

References 23 publications

Risk Factors and Prognosis of Spontaneously Ruptured Hepatocellular Carcinoma in Thailand

Risk Factors and Prognosis of Spontaneously Ruptured Hepatocellular Carcinoma in Thailand

Sarcopenia and intramuscular fat deposition are associated with poor survival in Indonesian patients with hepatocellular carcinoma: a retrospective study

Clinical Outcome and Predictive Factors of Variceal Bleeding in Patients with Hepatocellular Carcinoma in Thailand

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