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- W2891801962 abstract "Background: Worldwide, hepatocellular cancer (HCC) is the third leading cause of cancer death and occurs three times more commonly in males than females. In the US, HCC is increasing, especially in females over 50 years old. Current surveillance guidelines do not fully address gender differences in HCC. Methods: Clinical characteristics and survival data were compared between genders using a prospectively collected database of HCC patients (1993–2017). Patients with no viral, alcohol risk factors or other known liver disease were categorized as nonalcoholic fatty liver disease (NAFLD) or steatohepatitis (NASH). Results: Of 1206 patients, 307 (25%) were female and presented with older age (66.0 vs 61.6 years, p < 0.001), more NAFLD/NASH (28.7 vs 11.8%, p < 0.001), family with HCC (8.8 vs 5.3%, p = 0.039), and hypertension (67.2 vs 54.8%, p = 0.0007) despite no difference in BMI, hepatitis B/C, diabetes, or hyperlipidemia. Males were more likely to use alcohol and cigarettes. Females were more likely to have HCC surveillance, smaller tumor size, and less vascular involvement (7.5 vs 12%, p = 0.033). Males were less likely to meet Milan criteria, but more likely to undergo liver transplant. Median/mean survival was similar between genders. Multivariate Cox-proportional- hazards regression showed that age, smoking, family history and transplant were independent predictors of survival for males but age was the only predictor in females. Conclusion: Gender differences in HCC appear related to both behavioral risk factors (alcohol, smoking and surveillance) and biologic factors (AFP, family history). Females with HCC are more likely to have NAFLD/NASH, with older women having poorer survival. These gender disparities may lend support to future studies of gender-based HCC screening in patients with NAFLD/NASH.Tabled 1Females (n = 307)Males (n = 899)p ValueMean age (SD)66.0 (11.3)61.6 (11.3)<0.001Age 65+ years (%)164 (53.4)338 (27.6)<0.0001NAFLD or NASH (%)88 (28.7)106 (11.8)<0.001Family Hx of HCC (%)27 (8.8)18 (5.3)0.039Screened for HCC (%)90 (29.3)204 (22.7)0.02Smoking (%)114/300 (38)607/888 (68.4)0.0001Etoh use (%)37 (12.1)474 (52.9)0.0001AFP <20 (%)97(31.7)363 (40.6)0.006Mean Bilirubin (SD)1.39 (1.97)1.76 (2.74)0.03Mean Creatinine (SD)0.95 (0.88)1.09 (0.84)0.01Mean MELD (SD)10.0(4.36)10.8 (4.58)0.007Mean tumor size in cm (SD)5.3 (4.02)6.2 (4.58)0.003Tumors met Milan (%)147 (47.9)260 (40)0.05Vascular involvement (%)23 (7.5)108 (12)0.033Transplant (%)16 (5.2)77 (8.6)0.06%transplant/met Milan10.9%29.6%0.0001 Open table in a new tab" @default.
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- W2891801962 date "2018-03-01" @default.
- W2891801962 modified "2023-09-27" @default.
- W2891801962 title "Gender differences in hepatocellular cancer: should females with nonalcoholic fatty liver disease and steatohepatitis undergo surveillance for hepatocellular cancer?" @default.
- W2891801962 doi "https://doi.org/10.1016/j.hpb.2018.02.325" @default.
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