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Roles of Ethnicity in Survival of Hepatocellular Carcinoma Patients in Malaysia

  • Azmawati, M.N. (Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia) ;
  • Krisnan, R. (Department of Surgery, Hospital Selayang)
  • Published : 2012.12.31

Abstract

The incidence of hepatocellular carcinoma (HCC) in Malaysia for the year 2001 was 2.8 per 100,000 people. The mortality rate is increasing. A retrospective cohort study measuring the survival of HCC patients who received treatment in Selayang Hospital was conducted from 1 January 2003 to 31 December 2006. The main objectives of the study were to measure the survival of the patients and to understand the influencing factors, especially ethnicity. The subjects were newly diagnosed cases of HCC by CT scan and histopathological assessment who underwent futher investigations and treatments in Hospital Selayang (inception cohort). The survival time was measured from the date of diagnosis until the subjects died, or failed to follow-up at the end of the study period (31 December 2007). A total of 299 patients were selected with 95 patients dying, the majority among Chinese (39.1%). Subgroup analysis according to ethnicity proved significantly that Chinese patients who had smaller tumor, less number of nodules, low AFP level, Child Pugh Class A and received surgical treatment had a better median survival rate compared to other ethnic groups. Malay (cHR: 1.3, 95%CI; 0.89-1.85) and Indian (cHR: 1.3, 95%CI; 0.74-2.26) patients had a poor survival compared to Chinese patients, but not in the final model. Therefore ethnicity may play a role in survival of HCC patients, but not as a main hazard prognostic factor.

Keywords

References

  1. Avo A, Brian M, Nicelio S-L, et al (2010). Race, ethnicity, and socioeconomic status influence the survival of patients with hepatocellular carcinoma in the United States. Cancer, 116, 1367-77. https://doi.org/10.1002/cncr.24817
  2. Bosch FX, Ribes J (2000). Epidemiology of liver cancer in Europe. Canada J Gastroenterology, 14, 621-30.
  3. Bosch X, Ribes J, Borras J (1999). Epidemiology of primary liver cancer. Semin Liver Disease, 19, 271-85. https://doi.org/10.1055/s-2007-1007117
  4. Bosch FX, Ribes J, Diaz M, Cleries R (2004). Primary liver cancer: worldwide incidence and trends. Gastroenterology, 127, 5-16.
  5. Chin PL, Chu DZ, Clarke KG, et al (1999). Ethnic differences in the behavior of hepatocellular carcinoma. J Oncology, 85, 1931-6.
  6. Clegg LX, Li FP, Hankey BF, Chu K, Edwards BK (2002). Cancer survival among US whites and minorities: a SEER (Surveillance, Epidemiology, and End Results) Program population-based study. J Internal Med, 162, 1985-93. https://doi.org/10.1001/archinte.162.17.1985
  7. Dana S, Hegang C, Charles H (2006). Racial disparity in primary hepatocellular carcinoma: tumor stage at presentation, surgical treatment and survival. J Natl Med Assoc, 98, 1934-9.
  8. El-Sarag HB, Mason AC (1999). Rising incidence of hepatocellular carcinoma in the United States. New Engl J Med, 340, 745-50. https://doi.org/10.1056/NEJM199903113401001
  9. Lam CM, Yong JL, Chan AO, et al (2005). Better survival in female patients with hepatocellular carcinoma: oral contraceptive pills related? J Clinical Gastroenterology, 39, 533-9. https://doi.org/10.1097/01.mcg.0000165670.25272.46
  10. Marco V, Alfredo G, Andrea R, et al (2004). Resection versus percutaneous radiofrequency ablation in the treatment of hepatocellular carcinoma on cirrhotic liver. Ann Surgery, 240, 102-7. https://doi.org/10.1097/01.sla.0000129672.51886.44
  11. National Cancer Society of Malaysia (2004). Liver. Retrieve 3 June, 2012 from http://www.cancer.org.my/types_liver.php.
  12. Parkin DM, Bray F, Ferlay J, Pisani P (2000). Estimating the world cancer burden. Int J Cancer, 94, 153-6.
  13. Parkin DM (2001). Global cancer statistics in the year 2000. Lancet Oncol, 2, 533-43. https://doi.org/10.1016/S1470-2045(01)00486-7
  14. Philip LC, David ZJC, Ken GC, et al (1999). Ethnic differences in the behavior of hepatocellular carcinoma. Cancer, 85, 1931-6. https://doi.org/10.1002/(SICI)1097-0142(19990501)85:9<1931::AID-CNCR8>3.3.CO;2-F
  15. Ramsey WH, Wu GY (1995). Hepatocellular carcinoma: update on diagnosis and treatment. Diagnoses Diseases, 13, 81-91. https://doi.org/10.1159/000171490
  16. Shea KA, Fleming LE, Wilkinson JD, Wohler-Torres B, McKinnon JA (2001). Hepatocellular carcinoma incidence in Florida. J Oncology, 91, 1046-51.
  17. Trapido EJ, McCoy CB, Stein NS, et al (1990). Epidemiology of cancer among Hispanic males. Eur J Cancer, 65, 1657-62.