scholarly journals Differences in the impact of prognostic factors for hepatocellular carcinoma over time

2017 ◽  
Vol 108 (12) ◽  
pp. 2438-2444 ◽  
Author(s):  
Hidenori Toyoda ◽  
Takashi Kumada ◽  
Toshifumi Tada ◽  
Tsuyoki Yama ◽  
Kazuyuki Mizuno ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Prognostic Factors ◽  
The Impact ◽  
Over Time

Improved Survival in Chronic Myeloid Leukemia (CML) Since the Introductin of Imatinib Therapy - A Single Institution Historical Experience

Blood ◽  
2011 ◽  
Vol 118 (21) ◽  
pp. 2750-2750
Author(s):  
Hun Lee ◽  
Jorge E. Cortes ◽  
Susan O'Brien ◽  
Elias Jabbour ◽  
Guillermo Garcia-Manero ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Median Survival ◽  
Myeloid Leukemia ◽  
Research Funding ◽  
Chronic Phase ◽  
Imatinib Therapy ◽  
Blastic Phase ◽  
Group A ◽  
The Impact ◽  
Over Time

Abstract Abstract 2750 Background: Outcome of CML since introduction of imatinib therapy has improved. Aims: analyze improvement of CML outcome in different phases. Study Group: A total of 1,569 patients with CML referred since 1965, within 1 month from diagnosis, were reviewed and used to identify phase-specific prognostic factors: 1,148 chronic, 175 accelerated, 246 blastic. Results: The median survival was 8.9 years in chronic, 4.8 years in accelerated, and 6 months in blastic phase. In chronic phase, the 8-year survival was ≤ 15% before 1983, 42–65% from 1983 to 2000, and 87% since 2001 (Figure 1). Survival was worse in older patients (p=0.004), but less significant since 2001 (p=0.07). Survival by Sokal risk was significantly different before 2001 (p<0.001), but not since 2001 (p=0.4). In accelerated phase, survival improved over time (p<0.001); the 8-year survival in patients treated since 2001 was 75% (Figure 2). Survival by age was not different in years < 2001 (p=0.09), but was better since 2001 in patients ≤ 70 years (p=0.004). Multivariate analysis derived adverse factors since 2001: older age (p=0.049), increased marrow blasts (p=0.03). In blastic phase, the median survival improved over time (p<0.001), although it is only 7 months since 2001. Conclusions: Survival in CML significantly improved significantly since 2001, particularly so in chronic and accelerated phases. Imatinib therapy minimized the impact of known prognostic factors and Sokal risk in chronic phase, and accentuated the impact of age in accelerated and blastic phases. Disclosures: Cortes: Novartis: Consultancy; Novartis: Research Funding; BMS: Consultancy, Research Funding; Ariad: Consultancy, Research Funding; Pfizer: Consultancy, Research Funding. Kantarjian:Novartis: Consultancy; Novartis: Research Funding; Pfizer: Research Funding; BMS: Research Funding.

scholarly journals Survival improvement and prognosis for hepatocellular carcinoma: analysis of the SEER database

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jingli Ding ◽  
Zhili Wen
Keyword(s):  
Hepatocellular Carcinoma ◽  
Prognostic Factors ◽  
Lymph Node ◽  
The United States ◽  
Lymph Node Involvement ◽  
Seer Database ◽  
Old Patients ◽  
Female Ratio ◽  
Node Involvement ◽  
Over Time

Abstract Background Hepatocellular carcinoma (HCC) incidences have been increasing in the United States. This study aimed to examine temporal trend of HCC survival and determine prognostic factors influencing HCC survival within the U.S. population. Methods The Surveillance Epidemiology, and End Results (SEER) database was used to identify patients diagnosed with primary HCC from 1988 to 2015. Overall survival (OS) and disease-specific survival (DSS) were calculated by the Kaplan-Meier method. Univariate and multivariate Cox regression models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for prognostic factors and comparing survival between patients diagnosed at different periods (per 5-year interval). Results A total of 80,347 patients were included. The proportions of both young patients (< 45 years) and old patients (≥75 years) decreased over time (P < 0.001) and the male-to-female ratio increased over time (P < 0.001). Significant decreasing temporal trends were observed for HCC severity at diagnosis, including SEER stage, tumor size, tumor extent, and lymph node involvement (P < 0.001 for all). OS and DSS of patients with HCC improved over time (P < 0.001). After adjusting for patient and tumor characteristics and treatment difference, period of diagnosis retained an independent factor for improved DSS and its prognostic significance was evident for localized and regional HCC (P < 0.001), but not for distant HCC. On multivariate analyses, young age, female gender, Hispanic ethnicity, and married status were predictors favoring DSS, whereas a worse DSS was observed for patients with tumor > 5 cm, with vascular invasion, and with lymph node involvement. Patients treated with liver-directed therapy (HR = 0.54, 95% CI: 0.35–0.56), hepatic resection (HR = 0.35, 95% CI: 0.33–0.37), and transplantation (HR = 0.14, 95% CI: 0.13–0.15) had significantly longer DSS compared with those who received no surgery. In stratified analyses, the beneficial effects of surgical approach, regardless therapy type, were significant across all stages. Conclusions Our results indicate a significant improvement in survival for HCC patients from 1988 to 2015, which may be attributable to advances in early diagnosis and therapeutic approaches.

Living with hepatocellular carcinoma from the patient perspective: A longitudinal study.

2014 ◽  
Vol 32 (3_suppl) ◽  
pp. 373-373 ◽  
Author(s):  
Lissi Hansen ◽  
Gina M. Vaccaro ◽  
Susan J. Rosenkranz
Keyword(s):  
Quality Of Life ◽  
Hepatocellular Carcinoma ◽  
End Of Life ◽  
Symptom Management ◽  
Illness Perceptions ◽  
Qualitative Description ◽  
Qualitative Approaches ◽  
The Impact ◽  
Over Time

373 Background: Hepatocellular carcinoma (HCC) is a growing problem. For those diagnosed with terminal HCC, there is no curative treatment. Despite a high death rate, no longitudinal studies were found examining the illness experience of patients with HCC as they are approaching death. The aim of this study was to describe the experience of living with terminal HCC and how it may affect end of life care from the perspective of patients. Methods: This was a longitudinal, prospective mixed methods pilot study using quantitative and qualitative approaches. Semi-structured interviews were conducted with a convenience sub-sample of 14 patients with HCC once a month for a 6-month period. The interview guide included questions about living with HCC, pain and symptom management strategies, treatment decisions, and any current concerns of significance. Interview data were analyzed using qualitative description. Results: This poster reports on qualitative analysis of 45 interviews from the sub-sample. Eleven patients were male and 3 were female (mean age=61.5, range=54-68 years). Findings included 4 major themes: 1) illness perceptions, 2) uncertainty about treatments over time, 3) quality of life, and 4) coping strategies. Patients perceived HCC as isolating as compared to other cancers. Patients lacked information to prepare them for the journey ahead. They struggled with symptom management over time and chose to stop treatment, delay treatment in hope of improvement, or regretted starting treatment once underway. Conclusions: For patients, the impact of HCC and treatment side effects on quality of life was challenging and filled with uncertainty. From this first step, knowledge gained is serving as the foundation for a proposed larger scale study. The goal is to develop future interventions to address challenges (e.g., symptom management and treatment decision making) at the end of life for these understudied cancer patients.

scholarly journals Usefulness of Circulating CYFRA21-1 in Patients as a Biomarker in Patients Taking Sorafenib or Lenvatinib for Unresectable Hepatocellular Carcinoma

Reports ◽  
2021 ◽  
Vol 4 (3) ◽  
pp. 25
Author(s):  
Hitomi Takada ◽  
Leona Osawa ◽  
Yasuyuki Komiyama ◽  
Ryoh Kato ◽  
Natsuko Nakakuki ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Prognostic Factors ◽  
Poor Prognosis ◽  
Univariate Analysis ◽  
Evaluation Criteria ◽  
Additional Treatment ◽  
Cytokeratin 19 ◽  
Tumor Diameter ◽  
Unresectable Hepatocellular Carcinoma ◽  
The Impact

Background: This study investigated the impact of serum cytokeratin 19 fragment (CYFRA21-1) level on the clinical outcomes of patients with unresectable hepatocellular carcinoma (HCC) treated with sorafenib (SOR) or lenvatinib (LEN). Methods: A total of 71 cases with unresectable HCC taking SOR or LEN were included. Univariate and multivariate analyses were performed to identify the prognostic factors in patients taking SOR or LEN. Results: Among the 71 patients taking SOR or LEN, the frequency of cases showing high CYFRA21-1 levels after administration increased compared to before the administration. There was no association between the CYFRA21-1 level and the result of treatment response using modified Response Evaluation Criteria in Solid Tumors (mRECIST) 12 weeks after the administration. Univariate analysis identified a maximum intrahepatic tumor diameter of 70 mm or more, extrahepatic metastasis, baseline alpha-fetoprotein (AFP) ≥2000 ng/mL, baseline AFP-L3 index ≥15%, baseline des-gamma-carboxy prothrombin (DCP) ≥1000 mAU/mL, baseline CYFRA21-1 >3.5 ng/mL, 12-week mRECIST progressive disease (PD), 12-week DCP ratio ≥ 4, 12-week CYFRA21-1 ratio ≥2, administration period less than 12 weeks, ALBI grade 3 at PD, and no additional treatment after discontinuation of SOR/LEN as prognostic factors. Multivariate analysis revealed that AFP-L3 index ≥ 15%, 12-week mRECIST PD, 12-week DCP ratio ≥4, 12-week CYFRA21-1 ratio ≥2, administration period less than 12 weeks, and no additional treatment after discontinuation of SOR/LEN were independent factors. Conclusions: Patients with a high CYFRA21-1 level at baseline tend to have poor prognosis, and patients with a high CYFRA21-1 ratio 12 weeks after administration have poor prognosis. Serum CYFRA21-1 measurement may have additional effects on prognostic prediction, and it may be necessary to pay close attention to the transition to the next HCC treatment in cases whose CYFRA21-1 level is high.

scholarly journals Effectiveness of on-site education for quality assurance of screening ultrasonography for hepatocellular carcinoma

2016 ◽  
Vol 18 (3) ◽  
pp. 275 ◽  
Author(s):  
Joon-Il Choi ◽  
Seung Eun Jung ◽  
Woo Kyoung Jeong ◽  
Hyun Cheol Kim ◽  
Chandana Lall ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Quality Assurance ◽  
Failure Rate ◽  
The Other ◽  
Failure Rates ◽  
Imaging Evaluation ◽  
Clinical Imaging ◽  
The Impact ◽  
Annual Education ◽  
Over Time

Objective: To evaluate the usefulness of on-site education for clinical imaging evaluation using quality assurance (QA) testing of surveillance ultrasonography (US) for hepatocellular carcinoma (HCC). Material and methods: Thirty-eight medical institutes underwent on-site education in 2012 for QA testing of clinical imaging evaluation of surveillance US for HCC. Failure rates and mean scores of clinical imaging evaluation for surveillance US of the 2011 survey, the 2012 survey after on-site education and the 2013 survey were compared. Results: Failure rates and mean scores of the 2011 survey, the 2012 survey after education and the 2013 survey were 81.6%, 18.4%, 21.1% and 61.7, 82.7 and 74.6, respectively. Pair-wise analyses demonstrated that the failure rate of the 2011 survey was significantly larger compared to that observed in the other surveys. Mean score of the 2013 survey was worse than that of the 2012 survey after on-site education. Conclusions: On-site education positively impacts the failure rate and scores of clinical imaging evaluation of screening US for HCC. However, the impact may be reduced over time, and repeated, annual education might be necessary to maintain US quality.

The Therapist’s Reaction to a Patient’s Suicide

Crisis ◽  
2011 ◽  
Vol 32 (2) ◽  
pp. 99-105 ◽  
Author(s):  
Friedrich Martin Wurst ◽  
Isabella Kunz ◽  
Gregory Skipper ◽  
Manfred Wolfersdorf ◽  
Karl H. Beine ◽  
...  
Keyword(s):  
Emotional Responses ◽  
Well Being ◽  
Emotional Reaction ◽  
Emotional Reactions ◽  
Analog Scale ◽  
General Hospitals ◽  
Item Questionnaire ◽  
Retrospective Nature ◽  
The Impact ◽  
Over Time

Background: A substantial proportion of therapists experience the loss of a patient to suicide at some point during their professional life. Aims: To assess (1) the impact of a patient’s suicide on therapists distress and well-being over time, (2) which factors contribute to the reaction, and (3) which subgroup might need special interventions in the aftermath of suicide. Methods: A 63-item questionnaire was sent to all 185 Psychiatric Clinics at General Hospitals in Germany. The emotional reaction of therapists to patient’s suicide was measured immediately, after 2 weeks, and after 6 months. Results: Three out of ten therapists suffer from severe distress after a patients’ suicide. The item “overall distress” immediately after the suicide predicts emotional reactions and changes in behavior. The emotional responses immediately after the suicide explained 43.5% of the variance of total distress in a regression analysis. Limitations: The retrospective nature of the study is its primary limitation. Conclusions: Our data suggest that identifying the severely distressed subgroup could be done using a visual analog scale for overall distress. As a consequence, more specific and intensified help could be provided to these professionals.

Mechanisms of liver damage in COVID-19

2020 ◽  
Vol 1 (19) ◽  
pp. 39-46
Author(s):  
T. V. Pinchuk ◽  
N. V. Orlova ◽  
T. G. Suranova ◽  
T. I. Bonkalo
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Transplantation ◽  
Risk Factor ◽  
Liver Disease ◽  
Liver Function ◽  
Liver Damage ◽  
The World ◽  
Coronavirus Infection ◽  
The Impact ◽  
Analyze Data

At the end of 2019, a new coronavirus (SARS-CoV-2) was discovered in China, causing the coronavirus infection COVID-19. The ongoing COVID-19 pandemic poses a major challenge to health systems around the world. There is still little information on how infection affects liver function and the significance of pre-existing liver disease as a risk factor for infection and severe COVID-19. In addition, some drugs used to treat the new coronavirus infection are hepatotoxic. In this article, we analyze data on the impact of COVID-19 on liver function, as well as on the course and outcome of COVID-19 in patients with liver disease, including hepatocellular carcinoma, or those on immunosuppressive therapy after liver transplantation.

Has Aid Helped in Pakistan?

1997 ◽  
Vol 36 (4II) ◽  
pp. 947-957 ◽  
Author(s):  
Shahrukh Rafi Khan
Keyword(s):  
Economic Growth ◽  
Negative Impact ◽  
Negative Association ◽  
Causal Impact ◽  
The Impact ◽  
Over Time

This paper has a two-fold objective: first, to examine the terms on which Pakistan receives aid and whether its debt situation is sustainable, and second, to examine the impact of aid and debt on economic growth. It is found that there is little encouraging that can be said about how the terms on which Pakistan has received aid over time have changed, and its current debt situation is not sustainable. Also reported is the analysis done elsewhere which shows that aid has a negative (Granger) causal impact on GDP, and aid has a robust negative impact on economic growth after controlling for supplyside shocks. We provide various reasons for this negative association.

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