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Predictors and survival in hepatitis B-related hepatocellular carcinoma in New South Wales, Australia.
J Gastroenterol Hepatol. 2009 Mar; 24(3):436-42.JG

Abstract

BACKGROUND AND AIM

Incidence and mortality of hepatocellular carcinoma (HCC) has increased markedly over the last three decades in Australia. An increasing proportion of HCC cases is related to chronic viral hepatitis including hepatitis B virus (HBV) infection. However, there is very limited data on HBV-related HCC survival.

METHODS

Data on HBV-related HCC cases was obtained from a community-based linkage study. HCC cases notified to the New South Wales (NSW) Central Cancer Registry (CCR) during the period 1994-2002 were linked to HBV notifications from the NSW Health Department. Age, sex, country of birth, year of diagnosis, tumor stage were extracted from the CCR database. Survival analysis was conducted to determine median survival and identify predictors of survival.

RESULTS

Over the 9-year study period, 278 HCC cases were linked to chronic HBV infection. The majority of cases were male (83.5%) and overseas-born (93.6%); Asian-born cases accounted for 72.1%. Median survival following HCC diagnosis was 15.0 months. HCC survival was poorer among older age groups (P < 0.0001), and among cases with regional spread (hazard ratio, 3.23; 95% confidence interval, 1.83-5.69; P < 0.0001) and distant metastases (hazard ratio, 3.85; 95% confidence interval, 2.44-6.08; P < 0.0001). Sex, region of birth and study period (1994-1997 vs 1998-2002) were not associated with HCC survival.

CONCLUSION

The vast majority of HBV-related HCC were overseas-born, however, region of birth was unrelated to HCC survival. The continued extremely poor HCC survival, including lack of improvement in HCC survival in more recent years, suggests low uptake of HCC screening programs. Public health strategies including early diagnosis and appropriate referral for antiviral therapy assessment and increased HCC screening among high-risk populations are required to reduce HCC incidence and improve HCC survival.

Authors+Show Affiliations

School of Public Health and Community Medicine, The University of New South Wales, Sydney, New South Wales, Australia. v.nguyen@unsw.edu.auNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

19175834

Citation

Nguyen, Van T T., et al. "Predictors and Survival in Hepatitis B-related Hepatocellular Carcinoma in New South Wales, Australia." Journal of Gastroenterology and Hepatology, vol. 24, no. 3, 2009, pp. 436-42.
Nguyen VT, Amin J, Law MG, et al. Predictors and survival in hepatitis B-related hepatocellular carcinoma in New South Wales, Australia. J Gastroenterol Hepatol. 2009;24(3):436-42.
Nguyen, V. T., Amin, J., Law, M. G., & Dore, G. J. (2009). Predictors and survival in hepatitis B-related hepatocellular carcinoma in New South Wales, Australia. Journal of Gastroenterology and Hepatology, 24(3), 436-42. https://doi.org/10.1111/j.1440-1746.2008.05577.x
Nguyen VT, et al. Predictors and Survival in Hepatitis B-related Hepatocellular Carcinoma in New South Wales, Australia. J Gastroenterol Hepatol. 2009;24(3):436-42. PubMed PMID: 19175834.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Predictors and survival in hepatitis B-related hepatocellular carcinoma in New South Wales, Australia. AU - Nguyen,Van T T, AU - Amin,Janaki, AU - Law,Matthew G, AU - Dore,Gregory J, Y1 - 2008/10/21/ PY - 2009/1/30/entrez PY - 2009/1/30/pubmed PY - 2009/6/26/medline SP - 436 EP - 42 JF - Journal of gastroenterology and hepatology JO - J Gastroenterol Hepatol VL - 24 IS - 3 N2 - BACKGROUND AND AIM: Incidence and mortality of hepatocellular carcinoma (HCC) has increased markedly over the last three decades in Australia. An increasing proportion of HCC cases is related to chronic viral hepatitis including hepatitis B virus (HBV) infection. However, there is very limited data on HBV-related HCC survival. METHODS: Data on HBV-related HCC cases was obtained from a community-based linkage study. HCC cases notified to the New South Wales (NSW) Central Cancer Registry (CCR) during the period 1994-2002 were linked to HBV notifications from the NSW Health Department. Age, sex, country of birth, year of diagnosis, tumor stage were extracted from the CCR database. Survival analysis was conducted to determine median survival and identify predictors of survival. RESULTS: Over the 9-year study period, 278 HCC cases were linked to chronic HBV infection. The majority of cases were male (83.5%) and overseas-born (93.6%); Asian-born cases accounted for 72.1%. Median survival following HCC diagnosis was 15.0 months. HCC survival was poorer among older age groups (P < 0.0001), and among cases with regional spread (hazard ratio, 3.23; 95% confidence interval, 1.83-5.69; P < 0.0001) and distant metastases (hazard ratio, 3.85; 95% confidence interval, 2.44-6.08; P < 0.0001). Sex, region of birth and study period (1994-1997 vs 1998-2002) were not associated with HCC survival. CONCLUSION: The vast majority of HBV-related HCC were overseas-born, however, region of birth was unrelated to HCC survival. The continued extremely poor HCC survival, including lack of improvement in HCC survival in more recent years, suggests low uptake of HCC screening programs. Public health strategies including early diagnosis and appropriate referral for antiviral therapy assessment and increased HCC screening among high-risk populations are required to reduce HCC incidence and improve HCC survival. SN - 1440-1746 UR - https://www.unboundmedicine.com/medline/citation/19175834/Predictors_and_survival_in_hepatitis_B_related_hepatocellular_carcinoma_in_New_South_Wales_Australia_ L2 - https://doi.org/10.1111/j.1440-1746.2008.05577.x DB - PRIME DP - Unbound Medicine ER -