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Métodos Terapêuticos e Terapias MTCI
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Expert Rev Gastroenterol Hepatol ; 14(10): 1007-1011, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32730120

RESUMO

PURPOSE: To evaluate the characteristics and response to therapy for HCC in sub-Saharan Africa. PATIENTS AND METHODS: We retrospectively evaluated demographic, clinical and outcome variables of HCC in a referral clinic in Ethiopia from 2016 to 2018. Survival assessment was performed using the Mann-Whitney test. Associations between categorical variables was assessed using Pearson Chi-square test. RESULTS: We report 46 HCC cases with a median age of 54 years (IQR 45-62) and 50% female. Viral hepatitis was the most common underlying etiology, with 41% of subjects infected with hepatitis B virus (HBV) and 45% with hepatitis C. The median MELD was 12 (IQR 8-17), we found no association between survival and a MELD score 15, regardless of underlying disease (pr=0.61, p>0.05). 31% of individuals underwent supportive treatment with a median survival of 27 days (IQR 19-181), 18% used Sorafenib (median survival of 94 days, IQR 24-121), and trans-arterial chemoembolization (TACE) was utilized in 16% (median survival of 352 days, IQR 30-436). HBV cases were diagnosed younger (31% before the age of 40) and those on Tenofovir had a longer median survival than those off Tenofovir (121 vs 34 days). CONCLUSION: Our study found that antiviral treatment of HBV infection was associated with longer survival in HCC. Furthermore, Sorafenib seemed beneficial in patients that used this modality and NLR was a good prognostic factor.


Assuntos
Carcinoma Hepatocelular/terapia , Neoplasias Hepáticas/terapia , Antineoplásicos/uso terapêutico , Protocolos de Quimioterapia Combinada Antineoplásica/administração & dosagem , Antivirais/uso terapêutico , Carcinoma Hepatocelular/virologia , Quimioembolização Terapêutica , Cisplatino/administração & dosagem , Doxorrubicina/administração & dosagem , Doença Hepática Terminal/etiologia , Doença Hepática Terminal/fisiopatologia , Óleo Etiodado/administração & dosagem , Etiópia , Feminino , Hepatite B Crônica/complicações , Hepatite B Crônica/tratamento farmacológico , Hepatite C Crônica/complicações , Humanos , Neoplasias Hepáticas/virologia , Masculino , Pessoa de Meia-Idade , Cuidados Paliativos , Estudos Retrospectivos , Índice de Gravidade de Doença , Sorafenibe/uso terapêutico , Taxa de Sobrevida , Tenofovir/uso terapêutico , Resultado do Tratamento
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