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Conference Paper: Continuous improvement in survival outcomes of hepatocellular carcinoma over 2 decades

TitleContinuous improvement in survival outcomes of hepatocellular carcinoma over 2 decades
Authors
Issue Date2020
PublisherElsevier Inc. The Journal's web site is located at http://www.elsevier.com/locate/jamcollsurg
Citation
The American College of Surgeons (ACS) Clinical Congress, Virtual Congress, 3-7 October 2020. In Journal of the American College of Surgeons, 2020, v. 231 n. 4, Suppl. 2, p. e33 How to Cite?
AbstractIntroduction: To investigate the trend of post-treatment survival outcomes of hepatocellular carcinoma (HCC) patients by analysis of a prospective cohort of 5258 patients over a 20-year period. Methods: All HCC patients who were treated in a single-university center from 1997-2016 were included. Patients were divided into two 10-year period: period 1=1997-2006 (n = 2520), period 2=2007-2016(n = 2738). Results: In period 2, patients were older (59 vs 61, p < 0.001), had more medical comorbidities (39.8% vs 48.4%, p < 0.001) and remained male predominant (80% vs 80.1%, p = 0.552). There were more screen detected HCC (25.5% vs 32.9%, p < 0.001). Overall, patients' liver function at time of diagnosis has improved (MELD 9 vs 8, p < 0.001) and indocyanine green retention at 15mins (14.1% vs 12.5%, p < 0.001). Such improvement was likely related to the wide use of hepatitis B antiviral agent since 2003. In period 2, more patients underwent surgical treatment [liver transplant: 3.4% vs 5.9%, p < 0.001), resection (28.4% vs 31.1%, p < 0.001)] but the rate of ablation was similar (9.4% vs 10.3%). The overall survival of all patients have improved with median survival from 14.4 to 21.4 months. There was improvement in survival in patients who underwent liver resection, transarterial chemoembolization, systemic treatment and palliative treatment. Post-liver transplant survivals remained excellent and were similar across the decades(5-year survival 84.7% vs 85.1%, p = 0.837). Conclusion: A continuous improvement of survival outcomes for HCC patients were observed across most treatment categories (resection, TACE, systemic therapy and palliative care). Post-transplant survival was similar as the selection criteria for HCC was consistent and restrictive.
DescriptionSession: Hepatobiliary and Pancreas
Persistent Identifierhttp://hdl.handle.net/10722/287317
ISSN
2019 Impact Factor: 4.59
2015 SCImago Journal Rankings: 2.604

 

DC FieldValueLanguage
dc.contributor.authorWong, CLT-
dc.contributor.authorDai, WC-
dc.contributor.authorChan, ACY-
dc.contributor.authorCheung, TT-
dc.contributor.authorLo, CM-
dc.date.accessioned2020-09-22T02:59:11Z-
dc.date.available2020-09-22T02:59:11Z-
dc.date.issued2020-
dc.identifier.citationThe American College of Surgeons (ACS) Clinical Congress, Virtual Congress, 3-7 October 2020. In Journal of the American College of Surgeons, 2020, v. 231 n. 4, Suppl. 2, p. e33-
dc.identifier.issn1072-7515-
dc.identifier.urihttp://hdl.handle.net/10722/287317-
dc.descriptionSession: Hepatobiliary and Pancreas-
dc.description.abstractIntroduction: To investigate the trend of post-treatment survival outcomes of hepatocellular carcinoma (HCC) patients by analysis of a prospective cohort of 5258 patients over a 20-year period. Methods: All HCC patients who were treated in a single-university center from 1997-2016 were included. Patients were divided into two 10-year period: period 1=1997-2006 (n = 2520), period 2=2007-2016(n = 2738). Results: In period 2, patients were older (59 vs 61, p < 0.001), had more medical comorbidities (39.8% vs 48.4%, p < 0.001) and remained male predominant (80% vs 80.1%, p = 0.552). There were more screen detected HCC (25.5% vs 32.9%, p < 0.001). Overall, patients' liver function at time of diagnosis has improved (MELD 9 vs 8, p < 0.001) and indocyanine green retention at 15mins (14.1% vs 12.5%, p < 0.001). Such improvement was likely related to the wide use of hepatitis B antiviral agent since 2003. In period 2, more patients underwent surgical treatment [liver transplant: 3.4% vs 5.9%, p < 0.001), resection (28.4% vs 31.1%, p < 0.001)] but the rate of ablation was similar (9.4% vs 10.3%). The overall survival of all patients have improved with median survival from 14.4 to 21.4 months. There was improvement in survival in patients who underwent liver resection, transarterial chemoembolization, systemic treatment and palliative treatment. Post-liver transplant survivals remained excellent and were similar across the decades(5-year survival 84.7% vs 85.1%, p = 0.837). Conclusion: A continuous improvement of survival outcomes for HCC patients were observed across most treatment categories (resection, TACE, systemic therapy and palliative care). Post-transplant survival was similar as the selection criteria for HCC was consistent and restrictive.-
dc.languageeng-
dc.publisherElsevier Inc. The Journal's web site is located at http://www.elsevier.com/locate/jamcollsurg-
dc.relation.ispartofJournal of the American College of Surgeons-
dc.relation.ispartofClinical Congress of the American College of Surgeons-
dc.titleContinuous improvement in survival outcomes of hepatocellular carcinoma over 2 decades-
dc.typeConference_Paper-
dc.identifier.emailWong, CLT: wongtcl@hku.hk-
dc.identifier.emailDai, WC: daiwc@HKUCC-COM.hku.hk-
dc.identifier.emailChan, ACY: acchan@hku.hk-
dc.identifier.emailCheung, TT: cheung68@hku.hk-
dc.identifier.emailLo, CM: chungmlo@hkucc.hku.hk-
dc.identifier.authorityWong, CLT=rp01679-
dc.identifier.authorityChan, ACY=rp00310-
dc.identifier.authorityCheung, TT=rp02129-
dc.identifier.authorityLo, CM=rp00412-
dc.description.natureabstract-
dc.identifier.doi10.1016/j.jamcollsurg.2020.08.081-
dc.identifier.hkuros314167-
dc.identifier.volume231-
dc.identifier.issue4, Suppl. 2-
dc.identifier.spagee33-
dc.identifier.epagee33-
dc.publisher.placeUnited States-

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