Factors associated with long-term survival among patients diagnosed with distant stage hepatocellular carcinoma in the United States: a SEER analysis.

Eisses, B. (Bertha) (2015) Factors associated with long-term survival among patients diagnosed with distant stage hepatocellular carcinoma in the United States: a SEER analysis. thesis, Medicine.

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Abstract

Introduction Long-term survival in patients with distant hepatocellular carcinoma (HCC) is rare. Little is known about demographic characteristics, tumor grade and therapy of long-term survivors in patients with distant disease. The aim of this study is to analyze the patients with long-term survival. Material and Methods Data from patients diagnosed with distant stage HCC in the United States between 1973 and 2010 were retrieved from the Surveillance, Epidemiology and End Results (SEER) database. Short-term survival was defined as ≤ 4 months (75% of patients) and long-term survival as ≥ 12 months (10% of patients). Variables available for analysis included year of diagnosis, race/ethnicity, gender, age, grade and therapy. Logistic regression was used to identify factors associated with long-term survival. Among those surviving ≥ 12 months we used Cox proportional hazard models to evaluate factors associated with longer survival. Results Data from 4,546 patients (76% men, 55% whites) were analyzed: 3,953 short-term survivors and 536 long-term survivors. Median survival in the overall group, short-term survival group and long-term survival group was 1, 1 and 21 months respectively. Year of diagnosis, race/ethnicity, sex and age were significantly associated with membership in the long-term survival group. After adding grade to the model, these factors remained significant. After adjusting for therapy, which was significant, year of diagnosis and race/ethnicity were no longer significant. In our analysis of only patients in the long-term survival group, year of diagnosis, race/ethnicity and gender were associated with longer survival. After adjusting for therapy, which was significantly associated, sex was no longer significantly associated with longer survival and race/ethnicity association changed. Conclusion Distinct demographic features were observed between short- and long-term survivors of patients diagnosed with distant stage HCC. Despite the overall poor prognosis with late-stage hepatocellular carcinoma, a minority of people survive for extend period of time. The differences among short- and long-term survival suggest additional areas for research.

Item Type:	Thesis (Thesis)
Supervisor name:	Vries, Dr. J. de
Supervisor name:	Chang, Prof. S. and Department of Epidemiology and MD Anderson, Houston
Faculty:	Medical Sciences
Date Deposited:	25 Jun 2020 10:40
Last Modified:	25 Jun 2020 10:40
URI:	https://umcg.studenttheses.ub.rug.nl/id/eprint/144

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