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Clinical characteristics of patients with hepatocellular carcinoma in Austria - is there a need for a structured screening program?
- Source :
-
Wiener klinische Wochenschrift [Wien Klin Wochenschr] 2011 Sep; Vol. 123 (17-18), pp. 542-51. Date of Electronic Publication: 2011 Jul 29. - Publication Year :
- 2011
-
Abstract
- Background: We investigated the differences in clinical presentation of patients with hepatocellular carcinoma (HCC) at the time of diagnosis, before and after the publication of the European Association for the study of the Liver (EASL) guidelines of HCC management and screening.<br />Methods: Between 1991 and 2009, 907 patients were diagnosed with HCC at our department of which 850 were included in this study. Data regarding demography, liver function and tumor stage at the time of diagnosis were retrospectively collected. Differences in clinical characteristics and overall survival (OS) were compared before (period 1) and after (period 2) the publication of the EASL guidelines in 2001.<br />Results: In period 2, patients were more likely to be overweight (BMI: 26.1 vs. 27.5, p = 0.003), suffered more often from diabetes (25.4 vs. 37.3%, p = 0.001) and nonalcoholic steatohepatitis (NASH) (0.7 vs. 5.1%, p < 0.001). Alcoholic liver disease replaced viral hepatitis as the main etiology but not in the increasing number of patients with migration background where viral hepatitis (76.3%) remained the predominant etiology. No change in liver function and tumor stages at the time of HCC diagnosis was observed. Most patients presented with advanced incurable HCC. However, the median OS of all HCC patients increased in period 2 (7 vs. 14 months, p < 0.001) suggesting improvements of palliative therapy.<br />Conclusions: Patients with HCC are still predominantly diagnosed at incurable tumor stages, despite explicit European screening guidelines existing since 9 years. The implementation of a HCC surveillance program for cirrhotic patients in Austria seems to be warranted.
- Subjects :
- Adult
Aged
Aged, 80 and over
Austria
Carcinoma, Hepatocellular etiology
Carcinoma, Hepatocellular mortality
Carcinoma, Hepatocellular pathology
Cross-Sectional Studies
Female
Guideline Adherence
Humans
Liver Function Tests
Liver Neoplasms etiology
Liver Neoplasms mortality
Liver Neoplasms pathology
Male
Middle Aged
Neoplasm Staging
Risk Factors
Survival Analysis
Young Adult
Carcinoma, Hepatocellular diagnosis
Liver Neoplasms diagnosis
Mass Screening
Subjects
Details
- Language :
- English
- ISSN :
- 1613-7671
- Volume :
- 123
- Issue :
- 17-18
- Database :
- MEDLINE
- Journal :
- Wiener klinische Wochenschrift
- Publication Type :
- Academic Journal
- Accession number :
- 21800047
- Full Text :
- https://doi.org/10.1007/s00508-011-0033-9