PMID- 31144660
OWN - NLM
STAT- MEDLINE
DCOM- 20200114
LR  - 20200225
IS  - 2148-5607 (Electronic)
IS  - 1300-4948 (Print)
IS  - 1300-4948 (Linking)
VI  - 30
IP  - 6
DP  - 2019 Jun
TI  - Assessing the characteristics and feasibility of preventing early mortality in 
      patients with hepatocellular carcinoma.
PG  - 541-548
LID - 10.5152/tjg.2019.18654 [doi]
AB  - BACKGROUND/AIMS: To determine strategies to prevent early death (ED) and improve 
      the prognosis of patients with advanced hepatocellular carcinoma (HCC). MATERIALS 
      AND METHODS: Patients who were diagnosed with HCC from January 2012 to June 2017 
      were considered for the study. Those who survived for </=6 months from the date of 
      diagnosis were classified into the ED group (n=21) and those who survived for >/=12 
      months from the date of diagnosis were classified into the non-ED group (n=88). 
      RESULTS: There were significant differences between the ED and non-ED groups in 
      the following conditions: when the patient age was >/=80 years (38.1% vs. 14.8% 
      patients); maximum nodule size was >3 cm (90.5% vs. 27.3%); Child-Pugh class C 
      liver disease was seen (66.7% vs. 26.1%); tumor-node-metastasis (TNM) Stage 
      III-IV tumor was present (85.7% vs. 21.6%); BCLC stage C/D of liver cancer was 
      seen (81.0% vs. 21.6%); JIS score was >/=4 (52.4% vs. 3.4%); serum creatinine level 
      was >/=1.0 mg/dL (52.4% vs. 22.7%); and there was absence of aggressive treatments 
      such as hepatic resection, radiofrequency ablation, transarterial 
      chemoembolization, and chemotherapy (66.7% vs. 4.5%). Logistic regression 
      analysis identified maximum nodule size of >3 cm (p=0.005, OR=58.7, 95% 
      CI=3.43-1003.9), JIS score of >/=4 (p=0.021, OR=12.0, 95% CI=1.44-100.1), and 
      absence of aggressive treatments (p=0.006, OR=24.7, 95% CI=2.47-247.2) as 
      predictive factors for ED. The presence of aggressive treatments significantly 
      improved the 12-month survival rate of advanced HCC patients with BCLC stage C/D 
      (presence vs. absence: 78.3% vs. 7.4%), a maximum nodule size of >3 cm (76.7% vs. 
      7.7%), and a JIS score of >/=4 (60.0% vs. 0%). CONCLUSION: Although delayed 
      detection of HCC strongly increased the onset ED, the aggressiveness of HCC 
      treatment is not readily downgraded, and the most aggressive treatment possible 
      should be considered to prevent ED in patients with advanced HCC.
FAU - Watanabe, Masaaki
AU  - Watanabe M
AD  - Department of Gastroenterology, Kitasato University Medical Center, Kitamoto, 
      Saitama, Japan.
FAU - Yokomori, Hiroaki
AU  - Yokomori H
AD  - Department of General Internal Medicine, Kitasato University Medical Center, 
      Kitamoto, Saitama, Japan.
FAU - Takahashi, Yoshihito
AU  - Takahashi Y
AD  - Department of Surgery, Kitasato University Medical Center, Kitamoto, Saitama, 
      Japan.
FAU - Okada, Takemichi
AU  - Okada T
AD  - Department of Radiology, Kitasato University Medical Center, Kitamoto, Saitama, 
      Japan.
FAU - Shibuya, Akitaka
AU  - Shibuya A
AD  - Department of Risk Management and Health Care Administration, Kitasato University 
      School of Medicine, Kitamoto, Saitama, Japan.
FAU - Koizumi, Wasaburo
AU  - Koizumi W
AD  - Department of Gastroenterology, Kitasato University School of Medicine, Kitamoto, 
      Saitama, Japan.
LA  - eng
PT  - Evaluation Study
PT  - Journal Article
PL  - Turkey
TA  - Turk J Gastroenterol
JT  - The Turkish journal of gastroenterology : the official journal of Turkish Society 
      of Gastroenterology
JID - 9515841
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - *Antineoplastic Protocols
MH  - Carcinoma, Hepatocellular/*mortality/pathology/*therapy
MH  - Feasibility Studies
MH  - Female
MH  - Humans
MH  - Liver Neoplasms/*mortality/pathology/*therapy
MH  - Logistic Models
MH  - Male
MH  - Middle Aged
MH  - Mortality, Premature
MH  - Neoplasm Staging
MH  - Prognosis
MH  - Retrospective Studies
MH  - Risk Factors
MH  - Survival Rate
MH  - Treatment Outcome
PMC - PMC6565353
COIS- Conflict of Interest: The authors have no conflicts of interest to declare.
EDAT- 2019/05/31 06:00
MHDA- 2020/01/15 06:00
PMCR- 2019/06/01
CRDT- 2019/05/31 06:00
PHST- 2019/05/31 06:00 [entrez]
PHST- 2019/05/31 06:00 [pubmed]
PHST- 2020/01/15 06:00 [medline]
PHST- 2019/06/01 00:00 [pmc-release]
AID - tjg-30-6-541 [pii]
AID - 10.5152/tjg.2019.18654 [doi]
PST - ppublish
SO  - Turk J Gastroenterol. 2019 Jun;30(6):541-548. doi: 10.5152/tjg.2019.18654.