#OctoberIs4Livers campaign aims to ‘turn the tide’ during Liver Cancer Awareness Month
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Liver Cancer Awareness Month, celebrated every October, seeks to raise awareness about the third deadliest cancer in the United States, with approximately 41,000 new cases and as many as 30,000 deaths each year.
To educate physicians on liver cancer management and prevention while empowering patients impacted by liver cancer, the Global Liver Institute has launched a social media campaign with the hashtag, #OctoberIs4Livers.
Building upon its “Liver Cancer Lessons” education series and in-depth conversations with liver cancer experts, the #OctoberIs4Livers campaign is intended to unite the worldwide liver cancer community of patients, survivors, caregivers, advocates and experts to open a public dialogue around liver cancer and bring awareness to the forefront.
“There is no longer an excuse for the devastation that liver cancer causes for many patients and their families when early diagnosis and preventive measures could put a stop to the vast majority of tragedies,” Donna R. Cryer, JD, founder and CEO of the Global Liver Institute, said in a press release. “Political will and concerted investment in liver health will turn the tide. We are excited to expand this momentum alongside our global partners every day – but especially throughout October.”
In recognition of Liver Cancer Awareness Month, Healio revisits the latest news and research on interventions and comprehensive care that could make the difference for patients living with hepatocellular carcinoma, including cost-effective surveillance thresholds for HCC, how behavioral data could predict HCC in at-risk patients, potential benefits of robotic liver resection and the need for policies to curb increasing costs of liver cancer care.
Lowering HCC incidence threshold in guidelines cost-effective, may improve early detection
Research demonstrated that hepatocellular carcinoma surveillance is cost-effective at a lower incidence threshold of 0.7% in virologically cured patients with hepatitis C virus, underscoring the need to update clinical guidelines.
“Hepatitis C treatment represents cure, but some patients remain at risk of developing HCC, the most common form of liver cancer,” Jagpreet Chhatwal, PhD, director of the Institute for Technology Assessment at Massachusetts General Hospital and associate professor at Harvard Medical School, told Healio. “Clinical guidelines recommend routine screening for HCC if the annual incidence of HCC exceeds 1.5%. This recommendation is based on old data; therefore, we investigated the contemporary incidence threshold above which routine HCC screening is cost-effective.” Read more.
Treating hepatitis C ‘feasible’ in patients with HCC, improves overall survival
Failure to achieve sustained virological response and the presence of more advanced chronic liver disease were associated with mortality in patients with hepatitis C and hepatocellular carcinoma, according to a researcher at EASL Congress.
“It is well known that achieving a sustainable virological response after hepatitis C treatment reduces liver decompensation and HCC development with a positive impact on the overall survival,” Maria Fernanda Guerra Veloz, MD, PhD, of the Institute of Liver Studies at King’s College London, said. “All of these benefits in the reduction of liver-related morbidity/mortality and no liver-related mortality were already described in the interferon era and have resisted since across the whole spectrum of the disease with a direct-acting antiviral therapy.” Read more.
Behavioral data ‘has the potential’ to predict HCC in patients with hepatitis B
Scoring systems based on behavioral and clinical data outperformed existing scores in predicting risk for hepatocellular carcinoma in patients with chronic hepatitis B virus infection, according to data presented at the EASL Congress.
“The natural history of HCC begins with fibrosis, which leads to cirrhosis and then to HCC,” Clémence Ramier, MS, a doctoral student at Aix Marseille University, said. “Certain behavior may injure or foster liver disease progression. ... Accordingly, behavioral interventions are needed to prevent HCC occurrence. To date, 32 prediction models for HCC exist, each with their own scores. Only seven have been validated in Caucasian populations.” Read more.
Q&A: More research, policies needed to ‘curb the rising costs’ of liver cancer care
Patients with hepatocellular carcinoma carried a “significantly higher” cancer-related financial burden compared with those with cirrhosis, according to data published in Clinical Gastroenterology and Hepatology.
To analyze patient liabilities and Medicare payments in the first year following HCC diagnosis, Amit Singal, MD, medical director of the liver tumor program and clinical chief of hepatology at UT Southwestern Medical Center, and colleagues used the Surveillance, Epidemiology and End Results program-Medicare database to identify 4,525 adults diagnosed with HCC between 2011 and 2015. Researchers also generated a propensity-matched cohort of patients with cirrhosis to serve as the comparator group. Read more.
Robotic liver resection for HCC reduced length of hospital stay, ICU admissions
Robotic liver resection for hepatocellular carcinoma yielded better perioperative tolerability and may be a safe and effective alternative to open liver resection, according to research published in JAMA Surgery.
“Open hepatectomies may still be preferred in certain cases as an oncologically adequate procedure [for HCC]. Another minimally invasive approach to hepatectomy is robotic liver resection (RLR), which may also reduce the risk of conversion to open liver resection (OLR) during complex hepatectomies,” Fabrizio Di Benedetto, MD, PhD, of the hepato-pancreato-biliary surgery and liver transplantation unit at the University of Modena and Reggio Emilia in Italy, and colleagues wrote. “Despite these technical advantages, long-term oncologic outcomes of robotic surgery remain a hotly debated topic in surgical oncology because sparse data have been published thus far.” Read more.
Type 2 diabetes heightens risk for hepatic decompensation, HCC in patients with NAFLD
Type 2 diabetes was an independent predictor of hepatic decompensation and development of hepatocellular carcinoma among patients with nonalcoholic fatty liver disease, according to data.
“Previous studies have shown that type 2 diabetes is associated with hepatic decompensation among people with cirrhosis, hepatitis C virus and heavy alcohol consumption,” Daniel Q. Huang, MBBS, a visiting scholar at the NAFLD Research Center at the University of California, San Diego, and colleagues wrote in The Lancet Gastroenterology & Hepatology. “However, the risk of hepatic decompensation (development of ascites, hepatic encephalopathy or variceal bleeding) among individuals with NAFLD with and without type 2 diabetes has not been systematically assessed.” Read more.
1 in 10 patients with advanced liver disease develops liver-related event after HCV cure
The risk for hepatic decompensation and hepatocellular carcinoma remained constant after hepatitis C virus cure among patients with advanced chronic liver disease, underscoring the need for post-HCV risk stratification in the long term.
“Currently, more than 1 million individuals are being treated every year for hepatitis C virus; therefore, we need proper risk stratification to decrease resource utilization,” Georg Semmler, MD, of the division of gastroenterology and hepatology at the Medical University of Vienna, said at EASL Congress. “Compensated advanced chronic liver disease, also commonly known as compensated cirrhosis, is the target population for risk stratification tools because these patients are at risk to develop complications such as hepatic decompensation or hepatocellular carcinoma.” Read more.
Reference:
- Global Communities Rally around Third Deadliest Cancer – Liver Cancer. https://globalliver.org/global-communities-rally-around-third-deadliest-cancer-liver-cancer/. Accessed Oct. 10, 2023.
- October is Liver Cancer Awareness Month. https://www.aacr.org/patients-caregivers/awareness-months/liver-cancer-awareness-month/. Accessed Oct. 3, 2023.