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Hepatocellular Carcinoma Survival by Etiology: A SEER‐Medicare Database Analysis

In the United States, hepatocellular carcinoma (HCC) survival varies with tumor characteristics, patient comorbidities, and treatment. The effect of HCC etiology on survival is less clearly defined. The relationship between HCC etiology and mortality was examined using Surveillance, Epidemiology, an...

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Autores principales: Brar, Gagandeep, Greten, Tim F., Graubard, Barry I., McNeel, Timothy S., Petrick, Jessica L., McGlynn, Katherine A., Altekruse, Sean F.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7527688/
https://www.ncbi.nlm.nih.gov/pubmed/33024922
http://dx.doi.org/10.1002/hep4.1564
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author Brar, Gagandeep
Greten, Tim F.
Graubard, Barry I.
McNeel, Timothy S.
Petrick, Jessica L.
McGlynn, Katherine A.
Altekruse, Sean F.
author_facet Brar, Gagandeep
Greten, Tim F.
Graubard, Barry I.
McNeel, Timothy S.
Petrick, Jessica L.
McGlynn, Katherine A.
Altekruse, Sean F.
author_sort Brar, Gagandeep
collection PubMed
description In the United States, hepatocellular carcinoma (HCC) survival varies with tumor characteristics, patient comorbidities, and treatment. The effect of HCC etiology on survival is less clearly defined. The relationship between HCC etiology and mortality was examined using Surveillance, Epidemiology, and End Results–Medicare data. In a cohort of 11,522 HCC cases diagnosed from 2000 through 2014, etiologies were identified from Medicare data, including metabolic disorders (32.9%), hepatitis C virus (8.2%), alcohol (4.7%), hepatitis B virus (HBV, 2.1%), rare etiologies (0.9%), multiple etiologies (26.7%), and unknown etiology (24.4%). After adjusting for demographics, tumor characteristics, comorbidities and treatment, hazard ratios (HRs) and survival curves by HCC etiology were estimated using Cox proportional hazard models. Compared with HBV‐related HCC cases, higher mortality was observed for those with alcohol‐related HCC (HR 1.49; 95% confidence interval [95% CI] 1.25‐1.77), metabolic disorder–related HCC (HR 1.25; 95% CI 1.07‐1.47), and multiple etiology‐related HCC (HR 1.25; 95% CI 1.07‐1.46), but was not statistically significant for hepatitis C virus–related, rare disorder–related, and HCC of unknown etiology. For all HCC etiologies, there was short median survival ranging from 6.1 months for alcohol to 10.3 months for HBV. Conclusion: More favorable survival was seen with HBV‐related HCC. To the extent that HCC screening is more common among persons with HBV infection compared to those with other etiologic risk factors, population‐based HCC screening, applied evenly to persons across all HCC etiology categories, could shift HCC diagnosis to earlier stages, when cases with good clinical status are more amenable to curative therapy.
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spelling pubmed-75276882020-10-05 Hepatocellular Carcinoma Survival by Etiology: A SEER‐Medicare Database Analysis Brar, Gagandeep Greten, Tim F. Graubard, Barry I. McNeel, Timothy S. Petrick, Jessica L. McGlynn, Katherine A. Altekruse, Sean F. Hepatol Commun Original Articles In the United States, hepatocellular carcinoma (HCC) survival varies with tumor characteristics, patient comorbidities, and treatment. The effect of HCC etiology on survival is less clearly defined. The relationship between HCC etiology and mortality was examined using Surveillance, Epidemiology, and End Results–Medicare data. In a cohort of 11,522 HCC cases diagnosed from 2000 through 2014, etiologies were identified from Medicare data, including metabolic disorders (32.9%), hepatitis C virus (8.2%), alcohol (4.7%), hepatitis B virus (HBV, 2.1%), rare etiologies (0.9%), multiple etiologies (26.7%), and unknown etiology (24.4%). After adjusting for demographics, tumor characteristics, comorbidities and treatment, hazard ratios (HRs) and survival curves by HCC etiology were estimated using Cox proportional hazard models. Compared with HBV‐related HCC cases, higher mortality was observed for those with alcohol‐related HCC (HR 1.49; 95% confidence interval [95% CI] 1.25‐1.77), metabolic disorder–related HCC (HR 1.25; 95% CI 1.07‐1.47), and multiple etiology‐related HCC (HR 1.25; 95% CI 1.07‐1.46), but was not statistically significant for hepatitis C virus–related, rare disorder–related, and HCC of unknown etiology. For all HCC etiologies, there was short median survival ranging from 6.1 months for alcohol to 10.3 months for HBV. Conclusion: More favorable survival was seen with HBV‐related HCC. To the extent that HCC screening is more common among persons with HBV infection compared to those with other etiologic risk factors, population‐based HCC screening, applied evenly to persons across all HCC etiology categories, could shift HCC diagnosis to earlier stages, when cases with good clinical status are more amenable to curative therapy. John Wiley and Sons Inc. 2020-08-09 /pmc/articles/PMC7527688/ /pubmed/33024922 http://dx.doi.org/10.1002/hep4.1564 Text en Published 2020. This article is a U.S. Government work and is in the public domain in the USA. This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
spellingShingle Original Articles
Brar, Gagandeep
Greten, Tim F.
Graubard, Barry I.
McNeel, Timothy S.
Petrick, Jessica L.
McGlynn, Katherine A.
Altekruse, Sean F.
Hepatocellular Carcinoma Survival by Etiology: A SEER‐Medicare Database Analysis
title Hepatocellular Carcinoma Survival by Etiology: A SEER‐Medicare Database Analysis
title_full Hepatocellular Carcinoma Survival by Etiology: A SEER‐Medicare Database Analysis
title_fullStr Hepatocellular Carcinoma Survival by Etiology: A SEER‐Medicare Database Analysis
title_full_unstemmed Hepatocellular Carcinoma Survival by Etiology: A SEER‐Medicare Database Analysis
title_short Hepatocellular Carcinoma Survival by Etiology: A SEER‐Medicare Database Analysis
title_sort hepatocellular carcinoma survival by etiology: a seer‐medicare database analysis
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7527688/
https://www.ncbi.nlm.nih.gov/pubmed/33024922
http://dx.doi.org/10.1002/hep4.1564
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