Cirrhosis Patients with Nonalcoholic Steatohepatitis Are Significantly Less Likely to Receive Surveillance for Hepatocellular Carcinoma
| Autor: | Aijaz Ahmed, Hesam Tavakoli, Sammy Saab, Robert J. Wong, Zobair M. Younossi, Taft Bhuket, Benny Liu, Ann Robinson |
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| Rok vydání: | 2017 |
| Předmět: |
Adult
Liver Cirrhosis Male medicine.medical_specialty Alcoholic liver disease Carcinoma Hepatocellular Cirrhosis Physiology medicine.disease_cause Gastroenterology 03 medical and health sciences Liver disease 0302 clinical medicine Non-alcoholic Fatty Liver Disease Internal medicine medicine Humans Early Detection of Cancer Proportional Hazards Models Retrospective Studies Hepatitis B virus business.industry Proportional hazards model Liver Neoplasms Middle Aged Hepatology medicine.disease digestive system diseases Population Surveillance 030220 oncology & carcinogenesis Hepatocellular carcinoma Multivariate Analysis Etiology Female 030211 gastroenterology & hepatology business Safety-net Providers |
| Zdroj: | Digestive Diseases and Sciences. 62:2174-2181 |
| ISSN: | 1573-2568 0163-2116 |
| DOI: | 10.1007/s10620-017-4595-x |
| Popis: | Disparities in receipt of hepatocellular carcinoma (HCC) surveillance contribute to disparities in overall survival outcomes. We aim to evaluate disparities in receipt of routine HCC surveillance among patients with cirrhosis in a large urban safety-net hospital. Consecutive adults (age ≥ 18) with cirrhosis from July 1, 2014, to December 31, 2015, were retrospectively evaluated to determine rates of receiving appropriate HCC surveillance within 6 months and 1 year after diagnosis of cirrhosis. Rates of HCC surveillance were stratified by sex, race/ethnicity, and liver disease etiology. Multivariate Cox proportional hazards models were utilized to evaluate for predictors of receiving appropriate HCC surveillance. Among 157 cirrhosis patients enrolled [hepatitis C virus (HCV): 29.9%, hepatitis B virus: 13.4%, alcoholic cirrhosis: 44.6%, nonalcoholic steatohepatitis (NASH): 8.9%], mean age of cirrhosis diagnosis was 53.8 ± 9.0 years. Among these patients, 49% received (n = 77) HCC surveillance within 6 months and 78% (n = 123) were surveyed within 1 year of cirrhosis diagnosis. On multivariate analyses, patients with NASH cirrhosis were significantly less likely to receive HCC surveillance compared with chronic HCV cirrhosis patients (HR 0.44, 95% CI 0.19–0.99, p |
| Databáze: | OpenAIRE |
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