Natural history of advanced hepatocellular carcinoma in Crete. Association with hepatitis C virus
| Autor: | Elias A. Kouroumalis, Panagiotis Skordilis, Georgios Alexandrakis, Joanna Moschandrea, Nikolaos Charoulakis, O N Manousos, Maria Tzardi |
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| Rok vydání: | 1997 |
| Předmět: |
Male
medicine.medical_specialty Pathology Carcinoma Hepatocellular Hepatitis C virus Population medicine.disease_cause Gastroenterology Internal medicine medicine Humans Serologic Tests education Survival analysis Aged Proportional Hazards Models Analysis of Variance education.field_of_study Greece Hepatology medicine.diagnostic_test Proportional hazards model business.industry Liver Neoplasms Hazard ratio Middle Aged medicine.disease Hepatitis C Survival Analysis HBeAg Hepatocellular carcinoma Liver biopsy Disease Progression Female business |
| Zdroj: | European Journal of Gastroenterology & Hepatology. 9:981-988 |
| ISSN: | 0954-691X |
| DOI: | 10.1097/00042737-199710000-00011 |
| Popis: | Objective: To investigate the clinical characteristics of advanced hepatocellular carcinoma (HCC) in Crete and to analyse the natural course of the untreated disease. Participants: Seventy-three patients (62 men) were enrolled in a prospective 4-year study. Clinical and virological parameters were recorded. Diagnosis was based on either ultrasound guided liver biopsy or a pathognomonic increase in alpha-fetoprotein plus compatible imaging. Methods: Statistical analysis was performed using histograms, contingency tables and one-way analyses of variance to analyse the characteristics of the disease. For survival analysis Kaplan-Meier survival curves and Cox's proportional hazards models were constructed. Results: HCC in Crete is a mostly male disease (7:1 male:female ratio) and unlike in mainland Greece, it is mostly a hepatitis C virus (HCV)-related disease (54% HCV positive as opposed to only 13% in mainland Greece). Prognosis was associated with Okuda classification (Okuda stage III patients have a relative risk of dying that is seven to nine times higher than for Okuda stage I), the presence or absence of hepatitis B e antigen (HBeAg) and antibody to hepatitis B core antigen (anti-HBc). By contrast the presence of anti-HCV was not associated with a worse prognosis. A unit increase of albumin concentration was associated with an 11% decrease in the hazard rate. Conclusion: In general, Crete, despite the extremely similar population to the rest of Greece, resembles more closely the situation in Spain or Italy rather than mainland Greece. |
| Databáze: | OpenAIRE |
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