Survival and prognostic factors in 366 patients with compensated cirrhosis type B: a multicenter study

Realdi, Giuseppe; Fattovich, Giovanna; Hadziyannis, Stephanos J.; Schalm, Solko W.; Almasio, Piero Luigi; Sánchez-Tapias, J.M.; Christensen, Erik; Giustina, G.; Noventa, Franco

doi:10.1016/s0168-8278(94)80115-0

Cited by 283 publications

(211 citation statements)

References 20 publications

Supporting

Mentioning

191

Contrasting

Unclassified

Order By: Relevance

“…The annual rate of non-HCC-related liver deaths in this report was 3.9% and is similar to rates of 2.4% to 4% reported in other studies. 12,13 In addition, the annual rates for HCC development in our chronic hepatitis patients was 0.9%, and in cirrhosis patients was 2.3%, both of which were similar to HCC incidence rates of 1.5% to 3.8% in Europe 14,15 and rates of 0.7% to 2.2% in Asia. 16,17 Thus, deaths of liver disease complications and HCC development, the two major causes of mortality and morbidity from hepatitis B, appear to be similar among patients from different countries.…”

Section: Discussionsupporting

confidence: 77%

Treatment recommendations for chronic hepatitis B: An evaluation of current guidelines based on a natural history study in the United States

et al. 2008

View full text Add to dashboard Cite

Section: Discussionsupporting

confidence: 77%

Treatment recommendations for chronic hepatitis B: An evaluation of current guidelines based on a natural history study in the United States

et al. 2008

View full text Add to dashboard Cite

“…Significantly lower risk for HBsAg in persons aged 70 years or older might have resulted from spontaneous clearance of HBsAg over time (a 40% cumulative rate of HBsAg seroclearance has been observed among HBV carriers after 25 years) [38]. In addition, mortality due to HBV-related sequelae may lead to decreased prevalence by age 70 (probability of survival is 84% at 5 years and 68% at 10 years for HBsAg-seropositive patients with compensated cirrhosis) [39]. Following stratification by gender, age, and ethnicity, prevalence decreased with age among most ethnicities in this study.…”

Section: Discussionmentioning

confidence: 99%

Seroepidemiology of hepatitis B virus infection: analysis of mass screening in Hawaii

Tsai

Holck

Ricalde³

2008

Hepatol Int

View full text Add to dashboard Cite

Background Although hepatitis B seroprevalence has been studied extensively in California and New York, detailed information for other high-risk areas in the United States is lacking. To study current prevalence and risk for hepatitis B virus (HBV) infection in Hawaii, we analyzed cross-sectional data from Hawaii residents screened between July 2003 and April 2006. Methods We retrospectively reviewed the screening records of 3,989 participants recruited at health fairs and clinics. Prevalence and risk factors for HBV infection were estimated using univariate and multivariate logistic regression models. Results Total prevalence of hepatitis B surface antigen (HBsAg) was 3.6%. Gender, age, and ethnicity were independently associated with HBsAg seropositivity. In a multivariate logistic regression model, males were at increased risk for HBsAg compared with females (odds ratio [OR] = 1.53, 95% confidence interval [CI]: 1.09-2.16) and persons aged 70 years or older were less likely to test positive than those younger than 30 (OR = 0.25, 95% CI: 0.11-0.61). In addition, multivariate ORs of HBsAg seropositivity were 3.24 (95% CI: 1.04-10.09), 4.13 (95% CI: 1.66-10.29), and 7.47 (95% CI: 2.52-22.11) for Vietnamese, Chinese, and Pacific Islanders, respectively, compared with Whites. Conclusions This study furthers current knowledge of HBV epidemiology in areas with large populations of highrisk immigrants and demonstrates the relevance of screening programs for hepatitis B.

show abstract

“…Long-term studies indicate that 5-year survival rates range from 65% to 85%, and that once decompensation has occurred, 5-year survival ranges from 20% to 40%. [12][13][14][15] Between 5% and 10% of patients with compensated cirrhosis develop features of decompensation each year. 14,15 Waiting-List Time for OLT.…”

Section: Summary Of the Data Used For Baseline And Sensitivity Analysismentioning

confidence: 99%

“…[12][13][14][15] Between 5% and 10% of patients with compensated cirrhosis develop features of decompensation each year. 14,15 Waiting-List Time for OLT. The waiting-list time for liver transplantation varies according to the blood group and the local organ donation rate, with a median of 477 days in 1997 in the United States.…”

Section: Summary Of the Data Used For Baseline And Sensitivity Analysismentioning

confidence: 99%

Primary liver resection and salvage transplantation or primary liver transplantation in patients with single, small hepatocellular carcinoma and preserved liver function: An outcome-oriented decision analysis

et al. 2000

View full text Add to dashboard Cite

Two treatments are accepted for patients with solitary hepatocellular carcinoma Յ5 cm in size and with preserved hepatic function: (1) liver resection, which can be performed without delay but has a high recurrence rate, and (2) liver transplantation, which has a better long-term survival, but is not easily available because grafts are scarce. A third possibility is to offer liver resection first and liver transplantation for tumor recurrence or deteriorating liver function (''salvage'' transplantation). We investigated the implications of such a strategy with a Markov-based decision analytic model. Hepatocellular carcinoma (HCC) is one of the most common tumors worldwide, and its incidence is increasing in the western world because of the epidemics of the hepatitis C virus. 1 In patients aged less than 65 years, 2 therapies are currently accepted for early HCC (Յ5 cm): partial hepatectomy (PH) and orthotopic liver transplantation (OLT). 2,3 Although studies comparing the 2 treatments are retrospective and concern patients with disparate tumor characteristics and liver function, 4-6 it is agreed that OLT is preferable to partial hepatectomy in patients with hepatic insufficiency and in patients with more than 1 tumor, in whom the results of liver resection are poor.Patients with single tumors and preserved liver function present a therapeutic dilemma. Partial hepatectomy can cure the tumor immediately, with low mortality. The underlying cirrhosis, however, is responsible for a high recurrence rate, and the patient is exposed to the long-term complications of portal hypertension and hepatocellular failure. 7 OLT, by treating both the tumor and the cirrhosis, offers a better long-term survival. The tumor, however, can outgrow the criteria accepted for transplantation while waiting for donor organs, affecting the ultimate outcome as shown in a previous analysis. 2 For patients with a single resectable HCC, an alternative strategy to either partial hepatectomy or OLT would be to offer resection first and transplantation if the tumor recurs or if the liver function deteriorates (salvage OLT). Before such a strategy can be tested in a prospective controlled trial, the present study examines its implications in terms of patient outcome, graft use, and costs, using a decisional analysis model based on the data available in the literature. PATIENTS AND METHODS Decision Analytic ModelWe investigated the impact of 2 options: (1) primary liver transplantation and (2) partial hepatectomy followed by salvage liver transplantation (Fig. 1A) in patients with compensated cirrhosis and solitary HCC Յ5 cm in diameter, with a Markov simulation (Decision Maker 7

show abstract

Survival and prognostic factors in 366 patients with compensated cirrhosis type B: a multicenter study

Cited by 283 publications

References 20 publications

Treatment recommendations for chronic hepatitis B: An evaluation of current guidelines based on a natural history study in the United States

Treatment recommendations for chronic hepatitis B: An evaluation of current guidelines based on a natural history study in the United States

Seroepidemiology of hepatitis B virus infection: analysis of mass screening in Hawaii

Primary liver resection and salvage transplantation or primary liver transplantation in patients with single, small hepatocellular carcinoma and preserved liver function: An outcome-oriented decision analysis

Contact Info

Product

Resources

About