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Experience With Changing Etiology and Nontransplant Curative Treatment Modalities for Hepatocellular Carcinoma in a Real-Life Setting—A Retrospective Descriptive Analysis
Hepatocellular carcinoma (HCC) has variable etiological risk factors. Radiofrequency ablation (RFA) and surgical resection (SR) are frequently used as curative treatment options. In the present study, we assessed the etiological factors and efficacy of RFA and SR in patients with unifocal HCC in a r...
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| Published in: | Journal of clinical and experimental hepatology 2021-11, Vol.11 (6), p.682-690 |
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| creator | Tohra, Suneel Duseja, Ajay Taneja, Sunil Kalra, Naveen Gorsi, Ujjwal Behera, Arunanshu Kaman, Lileswar Dahiya, Divya Sahu, Srimanta Sharma, Balkrishan Singh, Virendra Dhiman, Radha K. Chawla, Yogesh |
| description | Hepatocellular carcinoma (HCC) has variable etiological risk factors. Radiofrequency ablation (RFA) and surgical resection (SR) are frequently used as curative treatment options. In the present study, we assessed the etiological factors and efficacy of RFA and SR in patients with unifocal HCC in a real-life setting.
Of 870 patients with HCC seen over a period of nine years, 785 patients were assessed for stage and etiological risk factors. Of these, 110 (14%) patients with single HCC who were either treated with RFA (n = 72) or SR (n = 38) were evaluated for their outcomes in terms of overall survival (OS) and disease-free survival (DFS) over 3 years.
Of 785 patients [median age 60 (range 51–65) years, males (n = 685, 87.3%)] with HCC, viral hepatitis [HBV and HCV with or without alcohol = 502 (63.9%)] was the most common etiology; nonalcoholic steatohepatitis (NASH) and alcohol as an etiology showed increase over the years. About 677 (86.2%) patients had evidence of cirrhosis; NASH and HBV were predominant causes in noncirrhotic patients. Even though the groups were not matched, in 110 patients subjected to either RFA [mean tumor size, 2.2 (1.9–2.8) cm] or SR [mean tumor size, 7.1 (4.8–9.7) cm], tumor progression was observed in 49 (68%) and 16 (42%) patients in RFA and SR groups, respectively, with superior DFS in the SR group (P < 0.01). Of total 31 deaths, 20 (27.8%) deaths were in the RFA group and 11 (28.9%) in the SR group with no difference in OS at 3 years.
Viral hepatitis with or without alcohol is the commonest etiological factor for HCC in Northern India; NASH and alcohol are increasing over the years. In a real-life setting, in patients with unifocal HCC, there is no difference in overall 3-year survival subjected to SR or RFA with better DFS in the SR group. |
| doi_str_mv | 10.1016/j.jceh.2021.02.002 |
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Of 870 patients with HCC seen over a period of nine years, 785 patients were assessed for stage and etiological risk factors. Of these, 110 (14%) patients with single HCC who were either treated with RFA (n = 72) or SR (n = 38) were evaluated for their outcomes in terms of overall survival (OS) and disease-free survival (DFS) over 3 years.
Of 785 patients [median age 60 (range 51–65) years, males (n = 685, 87.3%)] with HCC, viral hepatitis [HBV and HCV with or without alcohol = 502 (63.9%)] was the most common etiology; nonalcoholic steatohepatitis (NASH) and alcohol as an etiology showed increase over the years. About 677 (86.2%) patients had evidence of cirrhosis; NASH and HBV were predominant causes in noncirrhotic patients. Even though the groups were not matched, in 110 patients subjected to either RFA [mean tumor size, 2.2 (1.9–2.8) cm] or SR [mean tumor size, 7.1 (4.8–9.7) cm], tumor progression was observed in 49 (68%) and 16 (42%) patients in RFA and SR groups, respectively, with superior DFS in the SR group (P < 0.01). Of total 31 deaths, 20 (27.8%) deaths were in the RFA group and 11 (28.9%) in the SR group with no difference in OS at 3 years.
Viral hepatitis with or without alcohol is the commonest etiological factor for HCC in Northern India; NASH and alcohol are increasing over the years. In a real-life setting, in patients with unifocal HCC, there is no difference in overall 3-year survival subjected to SR or RFA with better DFS in the SR group.</description><identifier>ISSN: 0973-6883</identifier><identifier>EISSN: 2213-3453</identifier><identifier>DOI: 10.1016/j.jceh.2021.02.002</identifier><identifier>PMID: 34866847</identifier><language>eng</language><publisher>India: Elsevier B.V</publisher><subject>alcohol ; hepatitis B virus ; hepatitis C virus ; NASH ; nonalcoholic fatty liver disease ; Original</subject><ispartof>Journal of clinical and experimental hepatology, 2021-11, Vol.11 (6), p.682-690</ispartof><rights>2021 Indian National Association for Study of the Liver</rights><rights>2021 Indian National Association for Study of the Liver. Published by Elsevier B.V. All rights reserved.</rights><rights>2021 Indian National Association for Study of the Liver. Published by Elsevier B.V. All rights reserved. 2021 Indian National Association for Study of the Liver</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c455t-cac297d3e998ff86e112f199d9f8888de7426d0f8ff9aadfee0d8a610629f6023</citedby><cites>FETCH-LOGICAL-c455t-cac297d3e998ff86e112f199d9f8888de7426d0f8ff9aadfee0d8a610629f6023</cites><orcidid>0000-0001-8643-3664</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8617543/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8617543/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,315,733,786,790,891,27957,27958,53827,53829</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34866847$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Tohra, Suneel</creatorcontrib><creatorcontrib>Duseja, Ajay</creatorcontrib><creatorcontrib>Taneja, Sunil</creatorcontrib><creatorcontrib>Kalra, Naveen</creatorcontrib><creatorcontrib>Gorsi, Ujjwal</creatorcontrib><creatorcontrib>Behera, Arunanshu</creatorcontrib><creatorcontrib>Kaman, Lileswar</creatorcontrib><creatorcontrib>Dahiya, Divya</creatorcontrib><creatorcontrib>Sahu, Srimanta</creatorcontrib><creatorcontrib>Sharma, Balkrishan</creatorcontrib><creatorcontrib>Singh, Virendra</creatorcontrib><creatorcontrib>Dhiman, Radha K.</creatorcontrib><creatorcontrib>Chawla, Yogesh</creatorcontrib><title>Experience With Changing Etiology and Nontransplant Curative Treatment Modalities for Hepatocellular Carcinoma in a Real-Life Setting—A Retrospective Descriptive Analysis</title><title>Journal of clinical and experimental hepatology</title><addtitle>J Clin Exp Hepatol</addtitle><description>Hepatocellular carcinoma (HCC) has variable etiological risk factors. Radiofrequency ablation (RFA) and surgical resection (SR) are frequently used as curative treatment options. In the present study, we assessed the etiological factors and efficacy of RFA and SR in patients with unifocal HCC in a real-life setting.
Of 870 patients with HCC seen over a period of nine years, 785 patients were assessed for stage and etiological risk factors. Of these, 110 (14%) patients with single HCC who were either treated with RFA (n = 72) or SR (n = 38) were evaluated for their outcomes in terms of overall survival (OS) and disease-free survival (DFS) over 3 years.
Of 785 patients [median age 60 (range 51–65) years, males (n = 685, 87.3%)] with HCC, viral hepatitis [HBV and HCV with or without alcohol = 502 (63.9%)] was the most common etiology; nonalcoholic steatohepatitis (NASH) and alcohol as an etiology showed increase over the years. About 677 (86.2%) patients had evidence of cirrhosis; NASH and HBV were predominant causes in noncirrhotic patients. Even though the groups were not matched, in 110 patients subjected to either RFA [mean tumor size, 2.2 (1.9–2.8) cm] or SR [mean tumor size, 7.1 (4.8–9.7) cm], tumor progression was observed in 49 (68%) and 16 (42%) patients in RFA and SR groups, respectively, with superior DFS in the SR group (P < 0.01). Of total 31 deaths, 20 (27.8%) deaths were in the RFA group and 11 (28.9%) in the SR group with no difference in OS at 3 years.
Viral hepatitis with or without alcohol is the commonest etiological factor for HCC in Northern India; NASH and alcohol are increasing over the years. In a real-life setting, in patients with unifocal HCC, there is no difference in overall 3-year survival subjected to SR or RFA with better DFS in the SR group.</description><subject>alcohol</subject><subject>hepatitis B virus</subject><subject>hepatitis C virus</subject><subject>NASH</subject><subject>nonalcoholic fatty liver disease</subject><subject>Original</subject><issn>0973-6883</issn><issn>2213-3453</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><recordid>eNp9UcGO0zAQjRCIrZb9AQ7IRy4JtpM6iYSQqlJYpAISLOJoDfa4dZXawXYreuMj-Ay-ii_BbZcVXJjLWDPPb2beK4rHjFaMMvFsU20UritOOasoryjl94oJ56wu62Za3y8mtG_rUnRdfVFcxbihOQTlDeUPi4u66YTomnZS_Fx8GzFYdArJZ5vWZL4Gt7JuRRbJ-sGvDgScJu-8SwFcHAdwicx3AZLdI7kJCGmLufTWaxhsshiJ8YFc4wjJKxyG3QCBzCEo6_wWiHUEyAeEoVxag-QjppSH_fr-Y5arKfg4ojpRv8Sogh1P75mD4RBtfFQ8MDBEvLrNl8WnV4ub-XW5fP_6zXy2LFUznaZSgeJ9q2vs-86YTiBj3LC-173pcmhsGy40NbnZA2iDSHUHglHBe5M1qi-LF2fecfdli1rh8fhBjsFuIRykByv_7Ti7liu_l51g7bSpM8HTW4Lgv-4wJrm18agGOPS7KLmgbU3bjrEM5WeoysfHgOZuDKPy6LTcyKPT8ui0pFzS04JP_l7w7ssfXzPg-RmAWaa9xSCjOpmsbcgCS-3t__h_AxEgwH8</recordid><startdate>20211101</startdate><enddate>20211101</enddate><creator>Tohra, Suneel</creator><creator>Duseja, Ajay</creator><creator>Taneja, Sunil</creator><creator>Kalra, Naveen</creator><creator>Gorsi, Ujjwal</creator><creator>Behera, Arunanshu</creator><creator>Kaman, Lileswar</creator><creator>Dahiya, Divya</creator><creator>Sahu, Srimanta</creator><creator>Sharma, Balkrishan</creator><creator>Singh, Virendra</creator><creator>Dhiman, Radha K.</creator><creator>Chawla, Yogesh</creator><general>Elsevier B.V</general><general>Elsevier</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0001-8643-3664</orcidid></search><sort><creationdate>20211101</creationdate><title>Experience With Changing Etiology and Nontransplant Curative Treatment Modalities for Hepatocellular Carcinoma in a Real-Life Setting—A Retrospective Descriptive Analysis</title><author>Tohra, Suneel ; Duseja, Ajay ; Taneja, Sunil ; Kalra, Naveen ; Gorsi, Ujjwal ; Behera, Arunanshu ; Kaman, Lileswar ; Dahiya, Divya ; Sahu, Srimanta ; Sharma, Balkrishan ; Singh, Virendra ; Dhiman, Radha K. ; Chawla, Yogesh</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c455t-cac297d3e998ff86e112f199d9f8888de7426d0f8ff9aadfee0d8a610629f6023</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>alcohol</topic><topic>hepatitis B virus</topic><topic>hepatitis C virus</topic><topic>NASH</topic><topic>nonalcoholic fatty liver disease</topic><topic>Original</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Tohra, Suneel</creatorcontrib><creatorcontrib>Duseja, Ajay</creatorcontrib><creatorcontrib>Taneja, Sunil</creatorcontrib><creatorcontrib>Kalra, Naveen</creatorcontrib><creatorcontrib>Gorsi, Ujjwal</creatorcontrib><creatorcontrib>Behera, Arunanshu</creatorcontrib><creatorcontrib>Kaman, Lileswar</creatorcontrib><creatorcontrib>Dahiya, Divya</creatorcontrib><creatorcontrib>Sahu, Srimanta</creatorcontrib><creatorcontrib>Sharma, Balkrishan</creatorcontrib><creatorcontrib>Singh, Virendra</creatorcontrib><creatorcontrib>Dhiman, Radha K.</creatorcontrib><creatorcontrib>Chawla, Yogesh</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Journal of clinical and experimental hepatology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Tohra, Suneel</au><au>Duseja, Ajay</au><au>Taneja, Sunil</au><au>Kalra, Naveen</au><au>Gorsi, Ujjwal</au><au>Behera, Arunanshu</au><au>Kaman, Lileswar</au><au>Dahiya, Divya</au><au>Sahu, Srimanta</au><au>Sharma, Balkrishan</au><au>Singh, Virendra</au><au>Dhiman, Radha K.</au><au>Chawla, Yogesh</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Experience With Changing Etiology and Nontransplant Curative Treatment Modalities for Hepatocellular Carcinoma in a Real-Life Setting—A Retrospective Descriptive Analysis</atitle><jtitle>Journal of clinical and experimental hepatology</jtitle><addtitle>J Clin Exp Hepatol</addtitle><date>2021-11-01</date><risdate>2021</risdate><volume>11</volume><issue>6</issue><spage>682</spage><epage>690</epage><pages>682-690</pages><issn>0973-6883</issn><eissn>2213-3453</eissn><notes>ObjectType-Article-1</notes><notes>SourceType-Scholarly Journals-1</notes><notes>ObjectType-Feature-2</notes><notes>content type line 23</notes><notes>Joint first authors.</notes><abstract>Hepatocellular carcinoma (HCC) has variable etiological risk factors. Radiofrequency ablation (RFA) and surgical resection (SR) are frequently used as curative treatment options. In the present study, we assessed the etiological factors and efficacy of RFA and SR in patients with unifocal HCC in a real-life setting.
Of 870 patients with HCC seen over a period of nine years, 785 patients were assessed for stage and etiological risk factors. Of these, 110 (14%) patients with single HCC who were either treated with RFA (n = 72) or SR (n = 38) were evaluated for their outcomes in terms of overall survival (OS) and disease-free survival (DFS) over 3 years.
Of 785 patients [median age 60 (range 51–65) years, males (n = 685, 87.3%)] with HCC, viral hepatitis [HBV and HCV with or without alcohol = 502 (63.9%)] was the most common etiology; nonalcoholic steatohepatitis (NASH) and alcohol as an etiology showed increase over the years. About 677 (86.2%) patients had evidence of cirrhosis; NASH and HBV were predominant causes in noncirrhotic patients. Even though the groups were not matched, in 110 patients subjected to either RFA [mean tumor size, 2.2 (1.9–2.8) cm] or SR [mean tumor size, 7.1 (4.8–9.7) cm], tumor progression was observed in 49 (68%) and 16 (42%) patients in RFA and SR groups, respectively, with superior DFS in the SR group (P < 0.01). Of total 31 deaths, 20 (27.8%) deaths were in the RFA group and 11 (28.9%) in the SR group with no difference in OS at 3 years.
Viral hepatitis with or without alcohol is the commonest etiological factor for HCC in Northern India; NASH and alcohol are increasing over the years. In a real-life setting, in patients with unifocal HCC, there is no difference in overall 3-year survival subjected to SR or RFA with better DFS in the SR group.</abstract><cop>India</cop><pub>Elsevier B.V</pub><pmid>34866847</pmid><doi>10.1016/j.jceh.2021.02.002</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0001-8643-3664</orcidid><oa>free_for_read</oa></addata></record> |
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| language | eng |
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| source | ScienceDirect Journals; PubMed Central |
| subjects | alcohol hepatitis B virus hepatitis C virus NASH nonalcoholic fatty liver disease Original |
| title | Experience With Changing Etiology and Nontransplant Curative Treatment Modalities for Hepatocellular Carcinoma in a Real-Life Setting—A Retrospective Descriptive Analysis |
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