Survival in Asian Americans after treatments for hepatocellular carcinoma:

StephenW

J Clin Gastroenterol. 2010 Mar;44(3):e63-70.

Survival in Asian Americans after treatments for hepatocellular carcinoma: a
seven-year experience at UCLA.

Tong MJ, Chavalitdhamrong D, Lu DS, Raman SS, Gomes A, Duffy JP, Hong JC,
Busuttil RW.

The Dumont-UCLA Liver Cancer Center, Division of Digestive Diseases, David
Geffen School of Medicine, University of California, Los Angeles, CA, USA.
[email protected]

Abstract
BACKGROUND/RATIONALE: Hepatocellular carcinoma (HCC) is a common malignancy in
Asians and is related to the high incidence of chronic viral hepatitis in this
ethnic population. The aims of this study were to examine the tumor
characteristics and liver disease status in HCC patients of Asian ancestry and
determine their survival after treatments for HCC. RESULTS: Between September
2000 and December 2007, 278 patients, mean age 61.5 years, presented with HCC
to the University of California Los Angeles (UCLA) Liver Cancer Center.
Hepatitis B (HBV) infection was detected in up to 68% of Chinese, Korean, and
Vietnamese patients, whereas 60% of Japanese patients had Hepatitis C (HCV)
infection. Compared with HCC patients who presented with symptoms, those
detected by surveillance had more tumors within the Milan and University of
California, San Francisco (UCSF) criteria and more patients in
Child-Turcotte-Pugh class A. On the basis of a predefined UCLA treatment
algorithm, 83% of patients received surgical and/or loco-regional therapies.
Compared with other treatments, orthotopic liver transplantation (OLT), and
radiofrequency ablation had the highest overall patient survival (P<0.0001)
and OLT has the highest disease free survival rates (P<0.0001). Independent
baseline predictors for: (1) patient survival were HBV [hazard ratio (HR)
0.62, P=0.005], UCSF criteria (HR 0.46, P<0.0001), Child Turcotte Pugh class A
(HR 0.57, P=0.005), alphafetoprotein per log10 increase (HR 1.26, P=0.0012),
and alkaline phosphatase per log10 increase (HR 2.32, P=0.02); and for (2)
disease free survival were UCSF criteria (HR 0.66 P=0.007), aspartate
aminotransferase per log10 increase (HR 1.50, P=0.04), and age per year
increase (HR=1.02, P=0.04). The 4 Asian subgroups had similar survival rates.
CONCLUSIONS: HBV and Hepatitis C were associated with over 90% of HCC cases in
Asian Americans. HCC detected by surveillance identified more patients
eligible for surgical and loco-regional therapies, which improved the overall
and disease free survival.

PMID: 19745756 [PubMed - indexed for MEDLINE]



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