Single center analysis of therapy and outcomes of Hepatocellular carcinoma in Sub-Saharan Africa
Amir Sultan , Chimaobi M. Anugwom , Zerihun Wondifraw , Grace A. Braimoh , Abate Bane & Jose D. Debes
Received 29 Mar 2020, Accepted 24 Jul 2020, Accepted author version posted online: 30 Jul 2020
To evaluate the characteristics and response to therapy for HCC in the sub-Saharan Africa.
Patients and methods
We retrospectively evaluated demographic, clinical and outcome variables of individuals diagnosed with HCC in a referral clinic in Ethiopia from 2016 to 2018. Survival assessment was performed using the Mann-Whitney test. Associations between categorical variables was assessed using Pearson Chi-square test. A P-value ≤ 0.05 determined statistical significance.
Results
Forty-six HCC cases were reported, with a median age of 54 years (IQR 45 - 62) and half of them being female. Viral hepatitis was the most common underlying etiology of liver disease, with 41% of subjects infected with hepatitis B virus (HBV) and 45% with hepatitis C. The median MELD was 12 (IQR 8-17) and we found no association between survival and a MELD score </> 15, regardless of underlying disease (pr=0.61, p>0.05). Thirty-one percent of individuals underwent supportive treatment with a median survival of 27 days (IQR 19-181), 18% used Sorafenib (median survival of 94 days, IQR 24-121), and trans-arterial chemoembolization (TACE) with curative intent was utilized in 16% (median survival of 352 days, IQR 30-436). In those treated with sorafenib, a neutrophil-to-lymphocyte ratio (NLR) of <2.5 correlated with better survival (109 vs 68 days for NLR >2.5, p=0.01). HBV cases were diagnosed younger (31% before the age of 40) and those on Tenofovir had a longer median survival than those off Tenofovir (121 vs 34 days).
Conclusion
Our study found that antiviral treatment of HBV infection was associated with longer survival in HCC. Furthermore, Sorafenib was beneficial in patients that used this modality of treatment and the NLR was a good prognostic factor in those patients.
Keywords: Hepatocellular carcinoma, Ethiopia, Sorafenib, Outcomes作者: StephenW 时间: 2020-7-31 20:30
撒哈拉以南非洲地区肝细胞癌的治疗和预后的单中心分析
阿米尔·苏丹（Amir Sultan），Chimaobi M.Anugwom，Zerihun Wondifraw，格蕾丝·A·布雷莫（Grace A.
于2020年3月29日收到，于2020年7月24日接受，在网上发布的作者版本为：2020年7月30日