التفاصيل البيبلوغرافية
| العنوان: |
Prognostic factors of survival in HIV/HCV co‐infected patients with hepatocellular carcinoma: The CARCINOVIC Cohort. |
| المؤلفون: |
Gelu‐Simeon, Moana, Lewin, Maïté, Ostos, Maria, Bayan, Tatiana, Beso Delgado, Maria, Teicher, Elina, Layese, Richard, Roudot‐Thoraval, Françoise, Fontaine, Hélène, Sobesky, Rodolphe, Salmon‐Céron, Dominique, Samuel, Didier, Seror, Olivier, Nahon, Pierre, Meyer, Laurence, Duclos‐Vallée, Jean‐Charles, Petrov‐Sanchez, Ventzislava, Autran, Brigitte, Boufassa, Faroudy, Bourlière, Marc |
| المصدر: |
Liver International; Jan2019, Vol. 39 Issue 1, p136-146, 11p, 1 Diagram, 2 Charts, 1 Graph |
| مصطلحات موضوعية: |
LIVER cancer, HIV, HEPATITIS C virus, PROGNOSIS, THERAPEUTICS |
| مستخلص: |
Background & Aims: HIV/HCV co‐infected patients with hepatocellular carcinoma (HCC) have poorer survival than HCV mono‐infected patients. We aimed to evaluate the prognostic factors for survival. Methods: From 2006 to 2013, 55 incident HCCs among HIV+/HCV+ patients, from three ANRS cohorts, were compared with 181 HCCs in HIV−/HCV+ patients from the ANRS Cirvir cohort. Results: HIV+/HCV+ patients were younger (50 years [IQR: 47‐53] vs 62 [54‐70], P < 0.001), male (89% vs 63%, P < 0.001) than HIV−/HCV+ patients. At HCC diagnosis, both groups had a majority of non‐responders to anti‐HCV‐therapy, and HIV+/HCV+ patients had more frequently known a previous cirrhosis decompensation (31% vs 14%, P = 0.005). At diagnostic imaging, there were more infiltrative forms of HCC in HIV+/HCV+ group (24% vs 14%, P < 0.001), associated with tumour portal thrombosis in 29%. During a median follow‐up period of 11.96 [5.51‐27] months since HCC diagnosis, a majority of palliative treatments were decided in HIV+/HCV+ patients (51% vs 19%, P < 0.001). The 1 and 2‐year crude survival rates were 61% versus 78% and 47% versus 63%, P = 0.003 respectively. In a Cox model multivariate analysis adjusted for the cohort, age and sex, the most important prognostic factor for survival was the infiltrative form of the tumour (aRR: 8.10 [4.17‐15.75], P < 0.001). Conclusions: The radiological aggressiveness of the tumour is the best prognostic factor associated with poorer survival of HCC in HIV+/HCV+ patients. High α‐foetoprotein level and decompensated cirrhosis are other ones. This justifies a particular attention to the detection and the management of small nodules in this high‐risk population. [ABSTRACT FROM AUTHOR] |
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| قاعدة البيانات: |
Complementary Index |
