Evolving epidemiology of HCC in Spain.
Обработка статьи · этапы, ошибки и управление
Ошибки и ограничения
История · было → стало
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Sala Margarita, Pascual Sonia, Rota Roca Maria Rosa, Matilla Ana María, Campos Marta, Delgado Manuel, Ferrer María Teresa, Montero José Luís, González-Santiago Jesús Manuel, Guerrero Antonio, Aracil Carles, Rodríguez-Lope Carlos, Romero-Gutiérrez Marta, Sogbe Miguel, Vázquez-Rodríguez Sergio, Olmo Javier Fuentes, Mínguez Beatriz, Cortés-García Luís, Vallejo-Senra Nicolau, Unceta Paloma Rendón, Clos Ariadna, Díaz-Bethencourt Dácil, Sánchez Araceli García, Castro Raisa Quiñones, Bustamante Javier, Perelló Christie, Urquijo Ponce Juan José, Serra Hernán Andreu, Llamoza-Torres Camilo Julio, Montoliu Silvia, Fernández-Marcos Cristina, Guiberteau Ana, Hernández-Guerra Manuel, Vergara Mercedes, Fernández-López Alexia María, Valer López-Fando María Paz, Gutiérrez-García María Luisa, Hernáez-Alsina Tánia, Coll Susana, Cuyás Berta, Morillas María Julia, Olmedo Susana Rebolledo, Fernández-Bermejo Miguel, Roget Mercè, Ramos Irina Calvo, Pacheco Del Río Gemma, Rifà Raimon, Gacho Pilar Conde, Barrio Mónica Llorente, Gómez-Rubio Mariano, Peñas Irene, Serra Isabel, Cachero Alba, Reig María, Giraldez Álvaro, Guerrero Marta, Segarra José Xavier, Lledó José Luis, Díaz-González Álvaro, Delgado Carolina, Iñarrairaegui Mercedes, Rodríguez-González María Milagros, Lázaro María, Bermúdez-Ramos María, Lué Alberto, Molina Esther, Macías-Rodríguez Manuel Alberto, Rodríguez Manuel, Chiminazzo Valentina, Varela María
Аннотация
METHODS: This multicenter prospective study collected demographic and clinical data on primary liver cancer between October 2022 and January 2023. We conducted descriptive and comparative analyses with data collected in 2008 and 2014.
RESULTS: Of the 767 cases of primary liver cancer collected from 52 centers, 91% were diagnosed as HCC. The majority of patients were male (83.3%), average age 68 years, 80.7% had cirrhosis. The primary causes were alcohol (29.9% alone, 55% combined with other etiologies), liver disease related to metabolic syndrome (LDrMS, 23%) and hepatitis C (17.3%). Treatments included ablation (15.7%), systemic therapy (14.7%), and chemoembolization (14.6%). Data from 29 centers (n = 1,351) across three registries revealed a significant increase in LDrMS (from 4.9% to 24%) and HCC in non-cirrhotic livers (from 4.2% to 7.9%). Meanwhile, hepatitis C decreased sharply (from 43% to 17.5%). Alcohol-related cases remained stable. There was a slight increase in male patients and hypertension, diabetes, and obesity. Patients with cirrhosis diagnosed outside of screening programs presented with larger tumors and more advanced disease. This led to fewer evaluations for curative treatments.
CONCLUSIONS: Alcohol accounts for 30% of HCC cases and is the main etiology. The registry shows a decrease in hepatitis C-related HCC, an increase in LDrMS and HCC in non-cirrhotic livers. Surveillance was implemented in ∼80% of the recommended population. There is a need for improved screening and prevention strategies, particularly for alcohol abuse and LDrMS, to enhance HCC management.
IMPACT AND IMPLICATIONS: Our study showcases the involvement of numerous reference centers across Spain and examines over 1,300 patients to track the changing epidemiology of hepatocellular carcinoma (HCC) over 14 years. In patients with known liver cirrhosis, more than 80% of HCC diagnoses were made through screening leading to early-stage identification and curative treatment opportunities. Notably, there has been a shift in HCC etiology within the registries from hepatitis C to liver disease related to metabolic syndrome, with an increase in cases without cirrhosis. Findings indicate a need for the prevention and early detection of HCC, particularly focusing on alcohol and liver disease related to metabolic syndrome, along with greater involvement of health authorities, to improve the participation of at-risk patients in screening programs.