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

StephenW

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

    Download citation https://doi.org/10.1080/17474124.2020.1802246 CrossMark Logo CrossMark

Accepted author version
Abstract
Purpose

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

StephenW

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

    下载引文https://doi.org/10.1080/17474124.2020.1802246 CrossMark徽标CrossMark

接受的作者版本
抽象
目的

评估撒哈拉以南非洲地区肝癌的特征和对治疗的反应。
患者和方法

我们回顾性评估了2016年至2018年在埃塞俄比亚的一家转诊诊所中被诊断出患有HCC的个体的人口统计学，临床和结局变量。使用Mann-Whitney检验进行了生存评估。使用Pearson卡方检验评估类别变量之间的关联。 P值≤0.05确定了统计学显着性。
结果

据报告有46例HCC病例，中位年龄为54岁（IQR 45-62），其中一半为女性。病毒性肝炎是最常见的肝病基础病因，其中41％的受试者感染了乙型肝炎病毒（HBV），45％的患者感染了丙型肝炎。MELD中位数为12（IQR 8-17），我们发现生存率之间没有关联和MELD得分</> 15，与潜在疾病无关（pr = 0.61，p> 0.05）。 31％的患者接受了支持治疗，中位生存期为27天（IQR 19-181），18％的患者使用了索拉非尼（中位生存期为94天，IQR 24-121），以及经治愈的经动脉化学栓塞（TACE）意图使用率达到16％（中位生存期352天，IQR 30-436）。在接受索拉非尼治疗的患者中，中性粒细胞与淋巴细胞的比率（NLR）<2.5与更好的生存率相关（NLR> 2.5的患者分别为109天与68天，p = 0.01）。 HBV病例被诊断为年轻（40岁之前为31％），而使用Tenofovir的患者的中位生存期长于使用Tenofovir的患者（121天和34天）。
结论

我们的研究发现抗病毒治疗HBV感染与HCC生存期更长有关。此外，索拉非尼对使用这种治疗方式的患者有益，而NLR是这些患者的良好预后因素。
关键词：肝细胞癌，埃塞俄比亚，索拉非尼，结果