AI Article Synopsis
- The study analyzed over 34,000 patients with hepatocellular carcinoma (HCC) from 2003 to 2021, finding that non-alcoholic fatty liver disease (NAFLD) was the leading cause of HCC, followed by hepatitis C virus (HCV) and cryptogenic causes.
- Patients diagnosed between 2014 and 2021 tended to be older, more diverse in ethnicity, and had more comorbid conditions, leading to a lower 5-year survival rate compared to those diagnosed from 2003 to 2013.
- Males, Caucasians, African Americans, and Hispanics exhibited higher mortality rates, with NAFLD and cryptogenic liver disease also linked to worse outcomes.
Article Abstract
Background & Aim: Causes of hepatocellular carcinoma (HCC) may change as treatments become available for some liver diseases. We examined the distribution of HCC cause and survival of a nationwide cohort of insured patients.
Methods: Optum's de-identified Clinformatics Data Mart Database (CDM), 2003-2021.
Results: A total of 34707 patients with HCC were included: mean age: 68.3±11.6 years, 61% male, 62% Caucasian, 74% cirrhosis. Non-alcoholic fatty liver disease (NAFLD) was the most common etiology (38.9%), then hepatitis C virus (HCV) (25.3%), cryptogenic (18.0%), alcohol-associated liver disease (9.4%), other liver diseases (5.8%) and hepatitis B virus (HBV) at 2.6%. NAFLD patients were the oldest (mean age 71.1±11.2) and had the highest Charlson Comorbidity Index (CCI) (mean 10.5±3.9), while HCV were the youngest (mean age 64.2±9.2 years) and HBV had the lowest CCI (mean 7.2±4.4) (both <0.0001). The overall 5-year survival was 18.8% (95% CI 18.2-19.3) but was lower in the recent 2014-2021 period vs 2003-2013 (18.1% vs 19.5%, =0.003). The 2014-2021 cohort (inclusive of HCV treatment advances) was significantly older, with more females, fewer Caucasians, more African Americans, more Hispanics, fewer Asians, more cirrhosis, more NAFLD, and higher CCI (all <0.001). On multivariable analysis, males (aHR: 1.13), Caucasians (aHR: 1.46), African Americans (aHR: 1.53) and Hispanics (aHR: 1.28) vs Asians, 2014-2021 (vs 2003-2013) cohort (aHR: 1.12), NAFLD (aHR: 1.14) or cryptogenic liver disease (aHR: 1.45) were associated with increased mortality (all <0.001).
Conclusion: HCC patients in more recent time 2014-2021 were more likely to be older, more likely to have nonviral etiology, and had worse survival compared to those from 2003 to 2013.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10700040 | PMC |
| http://dx.doi.org/10.2147/JHC.S420603 | DOI Listing |
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