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Ann. hepatol ; 16(2): 255-262, Mar.-Apr. 2017. tab, graf
Artigo em Inglês | LILACS | ID: biblio-887230


ABSTRACT Background. Hepatocellular carcinoma (HCC) is the most common malignancy that develops in cirrhotic livers. Its clinical and epidemiological characteristics and mortality rates vary according to geographical region. The objective of this study was to evaluate the clinical profile, epidemiological characteristics, laboratory parameters, treatment and survival of patients with HCC. Material and methods. Patients with HCC seen between 2000 and 2012 were studied. The Kaplan-Meier method was used for survival analysis according to variables in question. Results. The study included 247 patients with a mean age of 60 ± 10 years. There was a predominance of males (74%). The main etiologies of HCC were HCV infection (55%), excessive alcohol consumption (12%), and HBV infection (8%). Liver cirrhosis was present in 92% of cases. The mean tumor number and diameter were 2 and 5 cm, respectively. Patients meeting the Milan criteria corresponded to 43% of the sample. Liver transplantation was performed in 22.4% of patients of the Milan subset and in 10% of the whole sample. The overall mean survival was 60 months, with a 1-, 3- and 5-year survival probability of 74%, 40% and 29%, respectively. Lower survival was observed among patients with alcoholic etiology. Survival was higher among patients submitted to liver transplantation (P < 0.001), TACE (P < 0.001), or any kind of treatment (P < 0.001). However, no difference was found for surgical resection (P = 0.1) or sorafenib (P = 0.1). Conclusion. Patients with HCC were mainly older men diagnosed at an advanced stage. Treatment was associated with better overall survival, but few patients survived to be treated.

Humanos , Transplante de Fígado , Quimioembolização Terapêutica , Carcinoma Hepatocelular/terapia , Técnicas de Ablação , Hepatectomia , Neoplasias Hepáticas/terapia , Antineoplásicos/uso terapêutico , Compostos de Fenilureia/uso terapêutico , Fatores de Tempo , Brasil/epidemiologia , Fatores de Risco , Resultado do Tratamento , Quimioembolização Terapêutica/efeitos adversos , Quimioembolização Terapêutica/mortalidade , Niacinamida/análogos & derivados , Carcinoma Hepatocelular/etiologia , Carcinoma Hepatocelular/mortalidade , Carcinoma Hepatocelular/patologia , Carga Tumoral , Estimativa de Kaplan-Meier , Centros de Atenção Terciária , Hepatectomia/efeitos adversos , Hepatectomia/mortalidade , Neoplasias Hepáticas/etiologia , Estadiamento de Neoplasias , Antineoplásicos/efeitos adversos
Ann Hepatol ; 14(3): 317-24, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-25864211


BACKGROUND: HBV/HCV coinfection is a common finding among hemodialysis patients. However, there is scarce information concerning the impact of HBV coinfection on the response to treatment of HCV-infected patients on hemodialysis. AIM: We aimed to compare the rate of sustained virologic response (SVR) to treatment with interferon-alfa (IFN) between hemodialysis patients with HBV/HCV coinfection and those with HCV-monoinfection. MATERIAL AND METHODS: HCV-infected patients on hemodialysis treated with IFN were included. Patients coinfected by HBV/HCV were compared to HCV-monoinfected patients, regarding clinical and biochemical features and rates of SVR. RESULTS: One hundred and eleven patients were treated. HBV/HCV coinfection was observed in 18/111 patients (16%). Coinfected patients were younger (p = 002), had more time on dialysis (p = 0.05) and showed a tendency to present a higher prevalence of septal fibrosis (p = 0.06). The analysis by intention to treat showed SVR of 56% among coinfected patients and 18% in HCV-monoinfected patients (p = 0.004). CONCLUSION: In conclusion, end-stage renal disease patients with HBV/HCV coinfection exhibit higher rate of SVR to HCV treatment than HCV-monoinfected patients. It is possible that factors related to the host immune response and viral interaction could explain the better response observed among coinfected patients.

Antivirais/uso terapêutico , Coinfecção , Hepatite B Crônica/complicações , Hepatite C Crônica/complicações , Falência Renal Crônica/terapia , Diálise Renal , Feminino , Seguimentos , Hepatite B Crônica/tratamento farmacológico , Hepatite C Crônica/tratamento farmacológico , Humanos , Falência Renal Crônica/complicações , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos