The inpatient economic and mortality impact of hepatocellular carcinoma from 2005 to 2009: analysis of the US nationwide inpatient sample

Mishra, Alita; Otgonsuren, Munkhzul; Venkatesan, Chapy; Afendy, Mariam; Erario, Madeline; Younossi, Zobair M.

doi:10.1111/liv.12201

Cited by 31 publications

(32 citation statements)

References 12 publications

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“…Despite these modest effects, sorafenib is currently the most effective chemotherapeutic option for metastatic HCC. Given the limited treatment options and the significant economic impact of end stage HCC, there is a great need for new and combination therapies (9). …”

Section: Introductionmentioning

confidence: 99%

Synergistic effects of ascorbate and sorafenib in hepatocellular carcinoma: New insights into ascorbate cytotoxicity

Rouleau

Antony

Bisetto

et al. 2016

Free Radical Biology and Medicine

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We investigated the mechanism of selective ascorbate-induced cytotoxicity in tumor cells, including Hep G2 cells, compared to primary hepatocytes. H2O2 formation was required for ascorbate cytotoxicity, as extracellular catalase treatment protected tumor cells. H2O2 generated by glucose oxidase treatment also caused cell killing, but treatment with a pharmacological dose (5-20 mM) of ascorbate was significantly more cytotoxic at comparable rates of H2O2 production, suggesting that ascorbate enhanced H2O2 cytotoxicity. This was further supported by the finding that ascorbate at a non-cytotoxic dose (1 mM) enhanced cell killing caused by glucose oxidase. Consistent with this conclusion, ascorbate treatment caused deregulation of cellular calcium homeostasis, resulting in massive mitochondrial calcium accumulation. Ascorbate acted synergistically with the chemotherapeutic sorafenib in killing Hep G2 cells, but not primary hepatocytes, suggesting adjuvant ascorbate treatment can broaden sorafenib's therapeutic range. Sorafenib caused mitochondrial depolarization and prevented mitochondrial calcium sequestration. Subsequent ascorbate addition further deregulated cellular calcium homeostasis promoting cell death. Additionally, we present the case of a patient with hepatocellular carcinoma (HCC) who had prolonged regression of a rib metastasis upon combination treatment with ascorbate and sorafenib, indicating that these studies have direct clinical relevance.

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Section: Introductionmentioning

confidence: 99%

Synergistic effects of ascorbate and sorafenib in hepatocellular carcinoma: New insights into ascorbate cytotoxicity

Rouleau

Antony

Bisetto

et al. 2016

Free Radical Biology and Medicine

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“…Chronic hepatitis C (CHC) is the most common cause of cirrhosis and its complications (hepatocellular carcinoma) in the United States and the Western world . CHC has been associated with increased mortality and resource utilization as well as impairment of patients' well‐being .…”

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confidence: 99%

“…C hronic hepatitis C (CHC) is the most common cause of cirrhosis and its complications (hepatocellular carcinoma) in the United States and the Western world. [1][2][3][4][5][6][7][8][9] CHC has been associated with increased mortality and resource utilization as well as impairment of patients' well-being. 4 Although hepatitis C virus (HCV), by itself, can negatively affect patient-reported outcomes (PROs), presence of cirrhosis, especially in its advanced form, can further deteriorate this impairment.…”

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confidence: 99%

Patient-reported outcomes in chronic hepatitis C patients with cirrhosis treated with sofosbuvir-containing regimens

et al. 2014

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Whether the presence of cirrhosis influences patient‐reported outcomes (PROs), including health‐related quality of life, during treatment with newly available anti‐HCV (hepatitis C virus) regimens is unclear. Our aim was to assess the association of cirrhosis with PROs in patients treated with sofosbuvir (SOF)‐containing regimens. Four PRO questionnaires (Short Form‐36 [SF‐36], Functional Assessment of Chronic Illness Therapy‐Fatigue [FACIT‐F], Chronic Liver Disease Questionnaire‐HCV (CLDQ‐HCV), and the Work Productivity and Activity Impairment Questionnaire: Specific Health Problem [WPAI‐SHP]) were administered to subjects receiving SOF and ribavirin (RBV; FUSION trial, N = 201, 34% cirrhosis; VALENCE trial: N = 333, 21% cirrhosis) and SOF, RBV, and pegylated interferon (Peg‐IFN; NEUTRINO trial: N = 327, 17% cirrhosis). HCV patients with cirrhosis showed significant impairment of PROs before initiation of treatment. During treatment, patients with cirrhosis treated with the IFN‐free regimen experienced moderate decline in their PRO scores (0.6%‐5.2% on a normalized scale of the summary scores; all P > 0.02). In contrast, patients with cirrhosis treated with IFN‐containing regimen showed decline in PRO scores that ranged from 3.4% to 16.0% (all P < 0.005). Nevertheless, by follow‐up week 12, no PRO decrement from baseline was observed in patients with cirrhosis regardless of the treatment regimen. Furthermore, in patients with cirrhosis with HCV who achieved sustained virological response at 12 weeks (SVR‐12), some improvement in PROs from baseline was observed. During treatment, changes in PRO scores were similar between patients with and without cirrhosis for both treatment regimens (all P > 0.05). Independent predictors of lower PROs in patients with cirrhosis included baseline depression, anxiety, fatigue, high HCV viral load, female gender, and receiving IFN‐containing treatment. Conclusions: Treatment with SOF+RBV with or without Peg‐IFN is tolerated by HCV patients with and without cirrhosis in terms of their PRO scores. After achieving SVR‐12 with the IFN‐free regimen, patients with cirrhosis showed improvement in some aspects of their PROs. (Hepatology 2014;59:2161–2169)

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“…Hepatocellular carcinoma (HCC) currently, affects 1.5% of the world population and reach approximately 15% of patients on the waiting list for liver transplantation (1,11,21) . Mishra et al (28) has demonstrated that the costs of treating patients with HCC in 2009 were around US$ 31 thousand, with total treatment costs of ap proximately US$ 2 billion in the USA.…”

Section: Introductionmentioning

confidence: 99%

“…Higher MELD score increases the overall cost on the waiting list for liver transplantation: a micro-costing analysis based study Brazil, the annual cost of heath care of each patient with advanced liver disease can reach more than 20 thousand dollars (1,2,11,27,28,38,44,49) . Some correlated disease has strong linkage with high costs procedures and hospitalizations.…”

Section: Introductionmentioning

confidence: 99%

Higher MELD score increases the overall cost on the waiting list for liver transplantation: a micro-costing analysis based study

Turri

Decimoni

Ferreira

et al. 2017

Arq. Gastroenterol.

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-Background -The pretransplant period is complex and includes lots of procedures. The severity of liver disease predisposes to a high number of hospitalizations and high costs procedures. Economic evaluation studies are important tools to handle costs on the waiting list for liver transplantation. Objective -The objective of the present study was to evaluate the total cost of the patient on the waiting list for liver transplantation and the main resources related to higher costs. Methods -A cost study in a cohort of 482 patients registered on waiting list for liver transplantation was carried out. In 24 months followup, we evaluated all costs of materials, medicines, consultations, procedures, hospital admissions, laboratorial tests and image exams, hemocomponents replacements, and nutrition. The total amount of each resource or component used was aggregated and multiplied by the unitary cost, and thus individual cost for each patient was obtained. $ 5,703.22 ± 9,318.68). Conclusion -Total costs on the waiting list for liver transplantation increased according to the patient's severity. Individually, hospitalizations, hemocomponents reposition and hepatocellular carcinoma treatment were the main cost drivers to the patient on the waiting list. The longer the waiting time, the higher the total cost on list, causing greater impact on health systems.

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The inpatient economic and mortality impact of hepatocellular carcinoma from 2005 to 2009: analysis of the US nationwide inpatient sample

Abstract: There is an increase in the number of inpatient cases of HCC. Although inpatient mortality is decreasing and the LoS is stable, the inpatient charges associated with HCC continue to increase.

Cited by 31 publications

References 12 publications

Synergistic effects of ascorbate and sorafenib in hepatocellular carcinoma: New insights into ascorbate cytotoxicity

Synergistic effects of ascorbate and sorafenib in hepatocellular carcinoma: New insights into ascorbate cytotoxicity

Patient-reported outcomes in chronic hepatitis C patients with cirrhosis treated with sofosbuvir-containing regimens

Higher MELD score increases the overall cost on the waiting list for liver transplantation: a micro-costing analysis based study

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