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

Weinmann, Arndt; Koch, Sandra; Niederle, Ina M.; Schulze‐Bergkamen, Henning; König, J.; Hoppe‐Lotichius, Maria; Hansen, Torsten; Pitton, Michael Bernhard; Düber, Christoph; Otto, Gerd; Schuchmann, Marcus; Galle, Peter R.; Wörns, Marcus A.

doi:10.1097/mcg.0b013e3182a8a793

Cited by 83 publications

(87 citation statements)

References 42 publications

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“…NAFLD is now reported as the principal etiology contributing to the incidence of HCC in North America [1], while the proportion of HCC attributed to NAFLD is growing rapidly in Europe [57]. The growing burden of NAFLD will lead to further increases in incidence of HCC.…”

Section: Discussionmentioning

confidence: 99%

Modeling NAFLD disease burden in China, France, Germany, Italy, Japan, Spain, United Kingdom, and United States for the period 2016–2030

Estes

Anstee

Arias-Loste

et al. 2018

Journal of Hepatology

1,191

678

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Background: Nonalcoholic fatty liver disease (NAFLD) with resulting nonalcoholic steatohepatitis (NASH) are increasingly a cause of cirrhosis and hepatocellular carcinoma (HCC) globally. This burden is expected to increase as epidemics of obesity, diabetes and metabolic syndrome continue to grow. The goal of this analysis was to use a Markov model to forecast NAFLD disease burden using currently available data. Methods:A model was used to estimate NAFLD and NASH disease progression in 8 countries based on data for adult prevalence of obesity and type 2 diabetes mellitus (DM). Published estimates and expert consensus were used to build and validate the model projections. Results:If obesity and DM level off in the future, we project a modest growth in total NAFLD cases (0-30%), between 2016-2030, with the highest growth in China as result of urbanization and the lowest growth in Japan as result of a shrinking population.However, at the same time, NASH prevalence will increase 15-56%, while liver mortality and advanced liver disease will more than double as result of an aging/increasing population.Conclusions: NAFLD and NASH represent a large and growing public health problem and efforts to understand this epidemic and to mitigate the disease burden are needed.If obesity and DM continue to increase at current and historical rates, both NAFLD and 4 NASH prevalence are expected to increase. Since both are reversible, public health campaigns to increase awareness and diagnosis, and to promote diet and exercise can help manage the growth in future disease burden.Lay summary: Nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH) can lead to advanced liver disease, and are occurring in increasing numbers in tandem with epidemics of obesity and diabetes. A mathematical model was built to understand how the disease burden associated with NAFLD and NASH will change over time. Results suggest increasing numbers of cases of advanced liver disease and liver-related mortality in the coming years. 5 BACKGROUNDNonalcoholic fatty liver disease (NAFLD) is a leading cause of liver disease globally [1][2][3]. This condition is characterized by excess liver fat in the absence of other causes such as alcohol consumption [4,5]. Obesity, type 2 diabetes mellitus (DM) and metabolic syndrome (MetS) are consistently identified as the most important risk factors for NAFLD [4,6].In order to classify the population, NAFLD may be divided into two groups: NAFL (steatosis only) or NASH (nonalcoholic steatohepatitis), where steatosis is accompanied by inflammation and ballooning. NASH frequently progresses to liver fibrosis [7] that is the main risk factor for liver-related mortality [8]. Odds of progression to advanced liver disease, including hepatic decompensation and hepatocellular carcinoma (HCC), are higher among those with NASH compared to those with NAFL [7]. Increasing age, obesity, DM and the presence of NASH have been consistently identified as risk factors for progression to cirrhosis [6,9].There is a...

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Section: Discussionmentioning

confidence: 99%

Modeling NAFLD disease burden in China, France, Germany, Italy, Japan, Spain, United Kingdom, and United States for the period 2016–2030

Estes

Anstee

Arias-Loste

et al. 2018

Journal of Hepatology

1,191

678

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“…Unlike other forms of cancer, hepatocellular carcinoma is consistently associated with chronic liver diseases (14,15). The majority of studies regarding HCC have focused on the cellular nucleus, with a number of variations in genes and their expression identified as potential carcinogenesis factors (16,17).…”

Section: Discussionmentioning

confidence: 99%

Associations between sequence variations in the mitochondrial DNA D-loop region and outcome of hepatocellular carcinoma

Wan

Peng

et al. 2016

Oncology Letters

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Abstract. The association between mitochondrial DNA (mtDNA) polymorphisms or mutations and the prognoses of cancer have been investigated previously, but the results have been ambiguous. In the present study, the associations between sequence variations in the mtDNA D-loop region and the outcomes of patients with hepatocellular carcinoma (HCC) were analysed. A total of 140 patients with HCC (123 males and 17 females), who were hospitalised to undergo radical resection, were studied. Polymerase chain reaction and direct sequencing were performed to detect the sequence variations in the mtDNA D-loop region. Multivariate and univariate analyses were conducted to determine important factors in the prognosis of HCC. A total of 150 point sequence variations were observed in the 140 cases (13 point mutations, 8 insertions, 20 deletions and 116 polymorphisms). The variation rate was 13.4% (150/1, 122). mtDNA nucleotide 150 (C/T) was an independent factor in the logistic regression for early/late recurrence of HCC. Patients with 150T appeared to have later recurrences. In a Cox proportional hazards regression model, hepatitis B virus DNA, Child-Pugh class, differentiation degree, tumour-node-metastasis (TNM) stage, nucleotide 16263 (T/C) and nucleotide 315 (N/insertion C) were independent factors for tumour-free survival time. Patients with the 16263T allele had a greater tumour-free survival time than patients with the 16263C allele. Similarly, patients with 315 insertion C had a superior tumour-free survival time when compared with patients with 315 N (normal). In the Cox proportional hazards regression model, recurrence type (early/late), Child-Pugh class, TNM stage and adjuvant treatment after tumour recurrence (none or one/more than one treatment) were independent factors for overall survival. None of the mtDNA variations served as independent factors. Patients with late recurrence, Child-Pugh class A, and low TNM stages and/or those who received more than one adjuvant treatment following tumour recurrence had favourable outcomes. mtDNA D-loop polymorphisms were associated with early recurrence and tumour-free survival time, but not with overall survival. mtDNA D-loop mutations in HCC were infrequent and lacked prognostic utility. The detection of mtDNA D-loop polymorphisms may assist in identifying risk factors for HCC prognosis, particularly for the short-term outcome, thereby aiding the construction of an appropriate therapeutic strategy.

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“…We read with great interest the article by Weinmann et al, 1 examining the trends in epidemiology, treatment, and survival of a large German cohort of hepatocellular carcinoma (HCC) patients between 1998 and 2009. The International Classification of Diseases for Oncology classifies HCC into HCC not otherwise specified (HCC-NOS), which accounts for the vast majority of HCC, scirrhous HCC, spindle cell variant HCC, clear-cell HCC, pleomorphic HCC, and fibrolamellar HCC (fHCC).…”

Section: To the Editormentioning

confidence: 99%

Long-term Survival of Fibrolamellar Hepatocellular Carcinoma Versus Conventional Hepatocellular Carcinoma

Njei¹

2014

Journal of Clinical Gastroenterology

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

Cited by 83 publications

References 42 publications

Modeling NAFLD disease burden in China, France, Germany, Italy, Japan, Spain, United Kingdom, and United States for the period 2016–2030

Modeling NAFLD disease burden in China, France, Germany, Italy, Japan, Spain, United Kingdom, and United States for the period 2016–2030

Associations between sequence variations in the mitochondrial DNA D-loop region and outcome of hepatocellular carcinoma

Long-term Survival of Fibrolamellar Hepatocellular Carcinoma Versus Conventional Hepatocellular Carcinoma

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