AIM：To conduct a multicentre retrospective review of virological response rates in Asians infected with genotype 1 chronic hepatitis C（CHC） treated with combination interferon and ribavirin and then to compare thei...AIM：To conduct a multicentre retrospective review of virological response rates in Asians infected with genotype 1 chronic hepatitis C（CHC） treated with combination interferon and ribavirin and then to compare their responses to that among Caucasians.METHODS：Asian patients infected with genotype 1 CHC treated at 4 Australian centres between 2001 to 2005 were identified through hospital databases.Baseline demographic characteristics,biochemical,virological and histological data and details of treatment were collected.Sustained virological responses（SVR） in this cohort were then compared to that in Caucasian subjects,matched by genotype,age,gender and the stage of hepatic fibrosis.RESULTS：A total of 108 Asians with genotype 1 CHC were identified.The end of treatment response（ETR） for the cohort was 79% while the SVR was 67%.Due to the relatively advanced age of the Asian cohort,only sixty-four subjects could be matched with Caucasians.The ETR among matched Asians and Caucasians was 81% and 56% respectively（P=0.003）,while the SVR rates were 73% and 36%（P 〈0.001） respectively.This difference remained significant after adjusting for other predictive variables. CONCLUSION： Genotype 1 CHC in Asian subjects is associated with higher rates of virological response compared to that in Caucasians.展开更多
Aim:Transarterial chemoembolisation(TACE)is recommended therapy for intermediate-stage hepatocellular carcinoma(HCC).However,the wide variations in outcomes reflect significant heterogeneity of this patient group.We e...Aim:Transarterial chemoembolisation(TACE)is recommended therapy for intermediate-stage hepatocellular carcinoma(HCC).However,the wide variations in outcomes reflect significant heterogeneity of this patient group.We evaluated the prognostic factors associated with survival in a real-world setting to identify those at high risk of a poor outcome.Methods:Patients with HCC who underwent initial TACE at six tertiary hospitals between 2009 to 2014 were included via an extensive search of hospital databases and electronic medical records.Overall survival(OS)was measured from the date of initial treatment to the date of death or last follow-up.Univariate and multivariate Cox regression analyses were used to assess the effects of baseline variables on post-TACE survival.Results:The majority of the 431 eligible patients were Caucasian(80%),male(87%),with a mean age of 66 years and had alcohol-related cirrhosis(43%).Most were Child-Pugh A(69%)with BCLC stage A(59%)or B(35%)disease,with a median OS of 28 months.On multivariate analysis,pre-treatment ascites(P=0.001)and larger HCC(P<0.001)were associated with worse overall survival,while higher serum albumin(P<0.001)and HBV(P=0.005)were associated with improved survival.Conclusion:Patients with advanced liver disease,including the presence of ascites and lower serum albumin,as well as those with greater tumour burden,have poorer outcomes following TACE treatment.Such findings provide a better understanding of the variation in survival after TACE and are helpful in facilitating selection and timely stage migration of patients undergoing this therapy.展开更多
文摘AIM：To conduct a multicentre retrospective review of virological response rates in Asians infected with genotype 1 chronic hepatitis C（CHC） treated with combination interferon and ribavirin and then to compare their responses to that among Caucasians.METHODS：Asian patients infected with genotype 1 CHC treated at 4 Australian centres between 2001 to 2005 were identified through hospital databases.Baseline demographic characteristics,biochemical,virological and histological data and details of treatment were collected.Sustained virological responses（SVR） in this cohort were then compared to that in Caucasian subjects,matched by genotype,age,gender and the stage of hepatic fibrosis.RESULTS：A total of 108 Asians with genotype 1 CHC were identified.The end of treatment response（ETR） for the cohort was 79% while the SVR was 67%.Due to the relatively advanced age of the Asian cohort,only sixty-four subjects could be matched with Caucasians.The ETR among matched Asians and Caucasians was 81% and 56% respectively（P=0.003）,while the SVR rates were 73% and 36%（P 〈0.001） respectively.This difference remained significant after adjusting for other predictive variables. CONCLUSION： Genotype 1 CHC in Asian subjects is associated with higher rates of virological response compared to that in Caucasians.
基金supported by an Australian Government Research Training Program(RTP)Scholarship,Monash University,Melbourne,Australia。
文摘Aim:Transarterial chemoembolisation(TACE)is recommended therapy for intermediate-stage hepatocellular carcinoma(HCC).However,the wide variations in outcomes reflect significant heterogeneity of this patient group.We evaluated the prognostic factors associated with survival in a real-world setting to identify those at high risk of a poor outcome.Methods:Patients with HCC who underwent initial TACE at six tertiary hospitals between 2009 to 2014 were included via an extensive search of hospital databases and electronic medical records.Overall survival(OS)was measured from the date of initial treatment to the date of death or last follow-up.Univariate and multivariate Cox regression analyses were used to assess the effects of baseline variables on post-TACE survival.Results:The majority of the 431 eligible patients were Caucasian(80%),male(87%),with a mean age of 66 years and had alcohol-related cirrhosis(43%).Most were Child-Pugh A(69%)with BCLC stage A(59%)or B(35%)disease,with a median OS of 28 months.On multivariate analysis,pre-treatment ascites(P=0.001)and larger HCC(P<0.001)were associated with worse overall survival,while higher serum albumin(P<0.001)and HBV(P=0.005)were associated with improved survival.Conclusion:Patients with advanced liver disease,including the presence of ascites and lower serum albumin,as well as those with greater tumour burden,have poorer outcomes following TACE treatment.Such findings provide a better understanding of the variation in survival after TACE and are helpful in facilitating selection and timely stage migration of patients undergoing this therapy.
