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Safcak D, Drazilova S, Gazda J, Andrasina I, Adamcova-Selcanova S, Barila R, Mego M, Rac M, Skladany L, Zigrai M, Janicko M, Jarcuska P. Nonalcoholic Fatty Liver Disease-Related Hepatocellular Carcinoma: Clinical Patterns, Outcomes, and Prognostic Factors for Overall Survival-A Retrospective Analysis of a Slovak Cohort. J Clin Med 2021; 10:3186. [PMID: 34300352 PMCID: PMC8306860 DOI: 10.3390/jcm10143186] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 07/13/2021] [Accepted: 07/16/2021] [Indexed: 02/07/2023] Open
Abstract
OBJECTIVE To compare NAFLD-related HCC and other etiology-related HCC and to describe predictive factors for survival in patients with NAFLD-related HCC independent of the BCLC staging system. METHODS We performed a multicenter longitudinal retrospective observational study of patients diagnosed with HCC during the period from 2010 through 2016. RESULTS 12.59% of patients had NAFLD-related HCC, and 21.91% had either NAFLD or cryptogenic etiology. NAFLD-related HCC patients were younger (p = 0.0007), with a higher proportion of women (p < 0.001) compared to other etiology-related HCC patients. The NAFLD group had a significantly lower proportion of patients with liver cirrhosis at the time of HCC diagnosis (p < 0.0001), and they were more frequently diagnosed with both diabetes and metabolic syndrome when compared to other etiology-related HCC (p < 0.0001). We did not find any difference in the overall survival or in the progression-free survival between NAFLD-related and other etiology-related HCC patients staged as BCLC B and BCLC C. NAFLD-related HCC patients with three or more liver lesions had a shorter overall survival when compared to patients with one or two liver lesions (p = 0.0097), while patients with baseline CRP values of ≥5 mg/L or with PLR ≥ 150 had worse overall survival (p = 0.012 and p = 0.0028, respectively). ALBI Grade 3 predicted worse overall survival compared to ALBI Grade 1 or 2 (p = 0.00021). In NAFLD-related HCC patients, PLR and ALBI remained significant predictors of overall survival even after adjusting for BCLC. CONCLUSION NAFLD-related HCC patients have a similar prognosis when compared to other etiology-related HCC. In NAFLD-related HCC patients, ALBI and PLR are significant predictors of the overall survival independent of the BCLC staging system.
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Affiliation(s)
- Dominik Safcak
- Department of Radiotherapy and Oncology, East Slovakia Institute of Oncology, Rastislavova 43, 041 91 Kosice, Slovakia; (D.S.); (I.A.)
| | - Sylvia Drazilova
- Internal Medicine Department, Hospital Poprad a.s., Banicka 803, 058 01 Poprad, Slovakia
- 2nd Department of Internal Medicine, P. J. Safarik University and L. Pasteur University Hospital, Trieda SNP 1, 040 11 Kosice, Slovakia; (J.G.); (M.J.); (P.J.)
| | - Jakub Gazda
- 2nd Department of Internal Medicine, P. J. Safarik University and L. Pasteur University Hospital, Trieda SNP 1, 040 11 Kosice, Slovakia; (J.G.); (M.J.); (P.J.)
| | - Igor Andrasina
- Department of Radiotherapy and Oncology, East Slovakia Institute of Oncology, Rastislavova 43, 041 91 Kosice, Slovakia; (D.S.); (I.A.)
| | - Svetlana Adamcova-Selcanova
- 2nd Department of Internal Medicine, HEGITO, F. D. Roosevelt University Hospital, Namestie L Svobodu 1, 975 17 Banska Bystrica, Slovakia; (S.A.-S.); (L.S.)
| | - Radovan Barila
- Oncological Cluster, Stefan Kukura Hospital in Michalovce, Spitalska Ulica 2, 071 01 Michalovce, Slovakia;
| | - Michal Mego
- 2nd Department of Oncology, Faculty of Medicine, Comenius University and National Oncology Institute of Slovakia, Klenova 1, 833 10 Bratislava, Slovakia;
| | - Marek Rac
- Department of Internal Medicine, Teaching Hospital Nitra, Spitalska 6, 949 01 Nitra, Slovakia;
| | - Lubomir Skladany
- 2nd Department of Internal Medicine, HEGITO, F. D. Roosevelt University Hospital, Namestie L Svobodu 1, 975 17 Banska Bystrica, Slovakia; (S.A.-S.); (L.S.)
| | - Miroslav Zigrai
- 1st Department of Internal Medicine, Ladislav Derer University Hospital in Bratislava, Limbova 5, 833 05 Bratislava-Kramare, Slovakia;
| | - Martin Janicko
- 2nd Department of Internal Medicine, P. J. Safarik University and L. Pasteur University Hospital, Trieda SNP 1, 040 11 Kosice, Slovakia; (J.G.); (M.J.); (P.J.)
| | - Peter Jarcuska
- 2nd Department of Internal Medicine, P. J. Safarik University and L. Pasteur University Hospital, Trieda SNP 1, 040 11 Kosice, Slovakia; (J.G.); (M.J.); (P.J.)
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Drazilova S, Babinska I, Gazda J, Halanova M, Janicko M, Kucinsky B, Safcak D, Martinkova D, Tarbajova L, Cekanova A, Jarcuska P. Epidemiology and clinical course of primary biliary cholangitis in Eastern Slovakia. Int J Public Health 2020; 65:683-691. [PMID: 32500239 DOI: 10.1007/s00038-020-01391-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Revised: 05/13/2020] [Accepted: 05/13/2020] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVE To determine both the incidence and the prevalence of primary biliary cholangitis (PBC) in Eastern Slovakia and to describe its clinical course and the response to ursodeoxycholic acid (UDCA). METHODS We recorded data of patients with PBC, who were followed up in gastroenterology and hepatology centers in Eastern Slovakia during the period from June 30, 1999, through June 30, 2019. RESULTS The annual incidence of PBC varied from 0.7 to 1.5 cases per 100,000 inhabitants between 2014 and 2018. PBC prevalence steadily increased from initial 10.2 cases per 100,000 inhabitants in 2014 to 14.9 cases per 100,000 inhabitants in June 2019. The mean age at the time of diagnosis was 56.3 ± 10.9 years. 95.7% of patients were females, and female/male gender ratio was 22.3:1. In June 2019, prevalence in the female population was 28 cases per 100,000 women. At the time of diagnosis, three-quarters of patients were symptomatic and 10% of patients had liver cirrhosis. The mean follow-up was 7.3 ± 5.2 years. Response to UDCA was observed in 72.1% of patients. Patients with higher baseline alkaline phosphatase (ALP) levels, liver cirrhosis at entry or at the end of follow-up and women younger than 45 years responded worse to UDCA. One-quarter of patients had liver cirrhosis at the end of follow-up. During follow-up, 1.6% of patients underwent liver transplantation and 5.5% of patients died. Five-year and 10-year liver-related mortalities were 2.7% and 4.3%, respectively. CONCLUSION PBC prevalence in Eastern Slovakia is increasing, and most of the patients respond to therapy with UDCA.
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Affiliation(s)
- Sylvia Drazilova
- Department of Internal Medicine, Hospital Poprad, Poprad, Slovakia
| | - Ingrid Babinska
- Department of Epidemiology, PJ Safarik University, Faculty of Medicine, Kosice, Slovakia.
| | - Jakub Gazda
- 2nd Department of Internal Medicine, Faculty of Medicine and L Pasteur University Hospital, PJ Safarik University, Kosice, Slovakia
| | - Monika Halanova
- Department of Epidemiology, PJ Safarik University, Faculty of Medicine, Kosice, Slovakia
| | - Martin Janicko
- 2nd Department of Internal Medicine, Faculty of Medicine and L Pasteur University Hospital, PJ Safarik University, Kosice, Slovakia
| | - Branislav Kucinsky
- 2nd Department of Internal Medicine, Faculty of Medicine and L Pasteur University Hospital, PJ Safarik University, Kosice, Slovakia
| | - Dominik Safcak
- 2nd Department of Internal Medicine, Faculty of Medicine and L Pasteur University Hospital, PJ Safarik University, Kosice, Slovakia
- Department of Radiotherapy and Oncology, Faculty of Medicine and Eastern Slovakia Institute of Oncology Kosice, PJ Safarik University, Kosice, Slovakia
| | | | - Lucia Tarbajova
- Department of Internal Medicine, Hospital Poprad, Poprad, Slovakia
| | - Anna Cekanova
- 2nd Department of Internal Medicine, Faculty of Medicine and L Pasteur University Hospital, PJ Safarik University, Kosice, Slovakia
| | - Peter Jarcuska
- 2nd Department of Internal Medicine, Faculty of Medicine and L Pasteur University Hospital, PJ Safarik University, Kosice, Slovakia
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Drazilova S, Kristian P, Janicko M, Halanova M, Safcak D, Dorcakova PD, Marekova M, Pella D, Madarasova-Geckova A, Jarcuska P. What is the Role of the Horizontal Transmission of Hepatitis B Virus Infection in Young Adult and Middle-Aged Roma Population Living in the Settlements in East Slovakia? Int J Environ Res Public Health 2020; 17:ijerph17093293. [PMID: 32397342 PMCID: PMC7246499 DOI: 10.3390/ijerph17093293] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 05/04/2020] [Accepted: 05/05/2020] [Indexed: 12/12/2022]
Abstract
Background: The aim of our work is to objectify the manner of transmission of HBV infection in young adult and middle-aged Roma people who live in the settlements. Methods: We used data from the cross-sectional study HepaMeta. We analyzed Roma people living in the settlements in East Slovakia, who have had HBsAg and anti HBc IgG antibodies examined. Results: We analyzed a cohort of 452 Roma participants with a mean of age 34.67 ± 9.14 years—159 (35.2%) were males. HBsAg positivity was diagnosed in 12.4% and the presence of anti HBc IgG antibodies was confirmed in 52% of participants. Prevalence of HBsAg positivity increases significantly with higher age, (p = 0.026), as well as the presence of anti HBc IgG antibodies (p < 0.0001). The prevalence of HBsAg positivity has doubled and anti HBc IgG positivity has tripled within two decades (<25 years vs. 35–45 years) in Roma settlements in East Slovakia. Conclusions: These findings allow us to express an opinion that horizontal transmission in adulthood may play an important role in the spreading of HBV infection.
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Affiliation(s)
- Sylvia Drazilova
- Department of Internal Medicine, Hospital Poprad and Faculty of Medicine, P.J. Safarik University, 058 01 Poprad, Slovakia;
| | - Pavol Kristian
- Department of Infectology and Travel Medicine, Faculty of Medicine, P.J. Safarik University and L. Pasteur University Hospital, 040 01 Kosice, Slovakia;
- Correspondence:
| | - Martin Janicko
- 2nd Department of Internal Medicine, Faculty of Medicine, P.J. Safarik University and L. Pasteur University Hospital, 040 11 Kosice, Slovakia; (M.J.); (P.J.)
| | - Monika Halanova
- Department of Epidemiology, Faculty of Medicine, P.J. Safarik University, 040 01 Kosice, Slovakia;
| | - Dominik Safcak
- East Slovakia Oncology Institute and Faculty of Medicine, P.J. Safarik University, 040 01 Kosice, Slovakia;
| | - Patricia Denisa Dorcakova
- Department of Infectology and Travel Medicine, Faculty of Medicine, P.J. Safarik University and L. Pasteur University Hospital, 040 01 Kosice, Slovakia;
| | - Maria Marekova
- Department of Medical and Clinical Biochemistry, Faculty of Medicine, P.J. Safarik University, 040 11 Kosice, Slovakia;
| | - Daniel Pella
- 2nd Department of Cardiology, East Slovak Institute of Cardiovascular Diseases and Faculty of Medicine, P.J. Safarik University, 040 11 Kosice, Slovakia;
| | - Andrea Madarasova-Geckova
- Department of Health Psychology, Faculty of Medicine, P.J. Safarik University, 040 11 Kosice, Slovakia;
| | - Peter Jarcuska
- 2nd Department of Internal Medicine, Faculty of Medicine, P.J. Safarik University and L. Pasteur University Hospital, 040 11 Kosice, Slovakia; (M.J.); (P.J.)
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