Older Patients With Hepatocellular Carcinoma Have More Advanced Disease, Lower Rates of Treatment, and Lower Survival.


GOALS:To evaluate age-specific disparities in cancer stage at diagnosis, receipt of treatment, and survival among adults with hepatocellular carcinoma (HCC). BACKGROUND:HCC has become the fastest rising cause of cancer-related deaths in the United States. The aging population coupled with the rising incidence of HCC will result in an emerging cohort of older patients with HCC placing significant burden health care systems. STUDY:Using 2003 to 2011 Surveillance, Epidemiology, and End Results data, a US population-based cancer registry, we retrospectively evaluated age-specific disparities in cancer stage at diagnosis, receipt of treatment, and survival among adults with HCC. Multivariate logistic regression models evaluated HCC stage at diagnosis and HCC treatment received. Multivariate Cox proportional hazard models evaluated long-term survival. RESULTS:Compared with HCC patients below 50 years old, patients aged 70 years or older were less likely to have HCC within Milan criteria [odds ratio, 0.58; confidence interval (CI), 0.54-0.63; P<0.001]. Older age was also associated with significantly lower rates of receiving HCC treatment. Even after adjusting for stage of disease, patients aged 70 years or older had the lowest odds of receiving any HCC treatment compared with patients below 50 years old (odds ratio, 0.52; CI, 0.46-0.60; P<0.001). On multivariate Cox regression, HCC patients aged 70 years or older had significantly lower survival compared with patients below 50 years old (hazards ratio, 1.22; CI, 1.15-1.30; P<0.001). CONCLUSIONS:Among US adults with HCC, patients aged 70 years or older were less likely to have HCC within Milan criteria at diagnosis, less likely to receive any HCC treatment, and had significantly lower long-term survival.


J Clin Gastroenterol


Yan M,Ha J,Aguilar M,Liu B,Frenette CT,Bhuket T,Wong RJ




Has Abstract


2017-04-01 00:00:00












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    abstract::A 24-year-old man with addisonian pernicious anemia, adult celiac disease and selective IgA deficiency is presented to emphasize the differential diagnosis of vitamin B12 deficient megaloblastic anemia in association with small intestinal mucosal abnormalities and the relationships between immunoglobulin deficiency, p...

    journal_title:Journal of clinical gastroenterology

    pub_type: 杂志文章


    authors: Quigley EM,Carmichael HA,Watkinson G

    更新日期:1986-06-01 00:00:00

  • Swallow evaluation during multichannel intraluminal impedance and pH: an alternate method to assess esophageal transit.

    abstract:BACKGROUND:Twenty-four-hour multichannel intraluminal impedance and pH (MII-pH) esophageal monitoring allows detection of both acid and nonacid gastroesophageal reflux episodes. The MII-pH catheter contains 6 impedance segments placed 3, 5, 7, 9, 15, and 17 cm above the lower esophageal sphincter (LES), plus a pH elect...

    journal_title:Journal of clinical gastroenterology

    pub_type: 杂志文章


    authors: Hila A,Chowdhury N,Hajar N,Castell DO

    更新日期:2011-11-01 00:00:00

  • Genetic Variations at rs3129891 and rs77005575 are Associated With Reduced Expression of Enteric α-defensins in IBD Patients.

    abstract:BACKGROUND AND AIMS:Human enteric antimicrobial peptides composed predominantly of human enteric α-defensins (HD5 and HD6) are important in the mucosal antimicrobial barrier. Previous studies have identified that genetic variations at rs2066844, rs2066845, rs2066847 are associated with diminished enteric α-defensins in...

    journal_title:Journal of clinical gastroenterology

    pub_type: 杂志文章


    authors: Deng Q,Tan G,Deng F,Zhi F

    更新日期:2020-07-01 00:00:00

  • Can pancreatitis be associated with amiodarone hepatotoxicity?

    abstract::We report a patient with classical features of amiodarone hepatotoxicity who died of progressive liver failure. Throughout the course of his illness, he had epigastric pain, nausea, vomiting, and persistent mild to moderate elevation of amylase and lipase in his serum and peritoneal fluid. Pancreatitis due to amiodaro...

    journal_title:Journal of clinical gastroenterology

    pub_type: 杂志文章


    authors: Sastri SV,Diaz-Arias AA,Marshall JB

    更新日期:1990-02-01 00:00:00

  • Biliary tract obstruction secondary to mycosis fungoides: a case report.

    abstract::Mycosis fungoides is a cutaneous T-cell lymphoma that can disseminate to multiple organs. We report a patient who presented with obstructive jaundice caused by isolated involvement of the extrahepatic biliary tree by mycosis fungoides. Initially, endoscopic examinations and biopsies of the biliary tree and liver faile...

    journal_title:Journal of clinical gastroenterology

    pub_type: 杂志文章


    authors: Madsen JA,Tallini G,Glusac EJ,Salem RR,Braverman I,Robert ME

    更新日期:1999-01-01 00:00:00

  • Liver tests in hyperthyroidism: effect of antithyroid therapy.

    abstract::Changes in liver biochemical test results have been described in hyperthyroid patients before and after antithyroid therapy. In the present study, we analyzed liver tests at diagnosis and after 6 weeks of treatment with propylthiouracil (PTU) in 43 patients with hyperthyroidism. At diagnosis, 60.5% of the patients had...

    journal_title:Journal of clinical gastroenterology

    pub_type: 杂志文章


    authors: Gürlek A,Cobankara V,Bayraktar M

    更新日期:1997-04-01 00:00:00

  • Pseudolipoma of Glisson's capsule. Report of six cases and review of the literature.

    abstract::We report six cases of pseudolipoma of Glisson's capsule. The patients ranged from 53 to 83 years old (mean 67.7 years), and all were men. Pseudolipoma of Glisson's capsule was detected by imaging studies before operation in two cases, and noted incidentally in the remaining four. Computed tomography demonstrated a su...

    journal_title:Journal of clinical gastroenterology

    pub_type: 杂志文章,评审


    authors: Sasaki M,Harada K,Nakanuma Y,Watanabe K

    更新日期:1994-07-01 00:00:00

  • Detection and localization of active gastrointestinal bleeding with multidetector row computed tomography angiography: a 5-year prospective study in one medical center.

    abstract:GOAL:To prospectively assess the utility of multidetector row computed tomography angiography (MDCTA) in the diagnosis of active gastrointestinal bleeding (GIB). BACKGROUND:MDCTA is a relatively recent advance in CT scanning technology enabling excellent vascular visualization and detection of various vascular abnorma...

    journal_title:Journal of clinical gastroenterology

    pub_type: 杂志文章


    authors: Sun H,Jin Z,Li X,Qian J,Yu J,Zhu F,Zhu H

    更新日期:2012-01-01 00:00:00

  • Hyperthyroidism and hepatic dysfunction. A case series analysis.

    abstract::Liver dysfunction in hyperthyroid patients has not been well characterized. We analyzed the clinical records of 43 patients with hyperthyroidism to define the spectrum of clinical and liver test abnormalities. The patients were divided into three categories: (a) 18 patients with uncomplicated hyperthyroidism (HT) (b) ...

    journal_title:Journal of clinical gastroenterology

    pub_type: 杂志文章


    authors: Fong TL,McHutchison JG,Reynolds TB

    更新日期:1992-04-01 00:00:00

  • Psychotropic agents in irritable bowel syndrome.

    abstract::The use of antidepressants to treat patients with irritable bowel syndrome (IBS) has been extended in recent years because of their possible neuromodulatory and analgesic effects, generally in doses that do not have antidepressant effects. There seems to be sufficient evidence to support the recommendation that psycho...

    journal_title:Journal of clinical gastroenterology

    pub_type: 杂志文章,评审


    authors: Wald A

    更新日期:2002-07-01 00:00:00

  • Fat-soluble Vitamin Deficiencies and Inflammatory Bowel Disease: Systematic Review and Meta-Analysis.

    abstract:BACKGROUND:Vitamin deficiency is frequently associated with inflammatory bowel disease (IBD). Supplementation of vitamins could thus serve as an adjunctive therapy. The present meta-analysis reviews the deficiencies and alterations in serum fat-soluble vitamins (A, D, E, and K) reported in IBD patients. MATERIALS AND ...

    journal_title:Journal of clinical gastroenterology

    pub_type: 杂志文章,meta分析,评审


    authors: Fabisiak N,Fabisiak A,Watala C,Fichna J

    更新日期:2017-11-01 00:00:00

  • GERD evaluation: time for a new paradigm?

    abstract::In the past there has been reliance on heartburn and acid regurgitation as the cardinal symptoms of gastro-esophageal reflux. Now it is recognized that diverse additional symptoms including extraesophageal manifestations are essential components of gastroesophageal reflux disease (GERD). Furthermore, previous reliance...

    journal_title:Journal of clinical gastroenterology

    pub_type: 杂志文章,评审


    authors: Modlin IM,Malfertheiner P,Hunt RH,Armstrong D,Holtmann G,Quigley EM,Spechler SJ

    更新日期:2007-03-01 00:00:00

  • Use of mesalazine in diverticular disease.

    abstract::Diverticular disease includes a spectrum of conditions sharing the underlying pathology of acquired diverticula of the colon: symptomatic uncomplicated diverticular disease, recurrent symptomatic uncomplicated diverticular disease, and complicated diverticular disease. Goals of therapy in diverticular disease should b...

    journal_title:Journal of clinical gastroenterology

    pub_type: 杂志文章,评审


    authors: Di Mario F,Comparato G,Fanigliulo L,Aragona G,Cavallaro LG,Cavestro GM,Franzé A

    更新日期:2006-08-01 00:00:00

  • Gunshot cholecystitis.

    abstract::A 15-year-old boy developed traumatic cholecystitis from a BB shot that lodged in his gallbladder. This is an unusual cause of gallbladder disease, and we review the literature. ...

    journal_title:Journal of clinical gastroenterology

    pub_type: 杂志文章,评审


    authors: Petersen JM,Knight TT

    更新日期:1995-12-01 00:00:00

  • Smoking and hyperpepsinogenemia are associated with increased risk for duodenal ulcer in Helicobacter pylori-infected patients.

    abstract:BACKGROUND:Although Helicobacter pylori has been established as a major etiologic factor of chronic gastritis and makes an important contribution to peptic ulceration, the reason why H. pylori causes different gastroduodenal diseases in different people is at present not clear. GOALS:The aim of this study is to identi...

    journal_title:Journal of clinical gastroenterology

    pub_type: 杂志文章


    authors: Chen TS,Lee YC,Li FY,Chang FY

    更新日期:2005-09-01 00:00:00

  • Motility of the transverse colon used for esophageal replacement.

    abstract::The authors studied the motility of transverse colon used for reconstruction of the pharyngogastric transit after esophagectomy. The study included 10 patients who underwent esophagectomy 15 to 201 months (median, 48.5 months) before motility evaluation. Nine patients underwent operation because of caustic injury and ...

    journal_title:Journal of clinical gastroenterology

    pub_type: 杂志文章


    authors: Dantas RO,Mamede RC

    更新日期:2002-03-01 00:00:00

  • Comparison of distribution of intraesophageal pH during nighttime recumbency among patients with gastroesophageal reflux disease.

    abstract:BACKGROUND:Nighttime reflux has been demonstrated to be associated with a more aggressive presentation of gastroesophageal reflux disease (GERD). However, it has remained unknown until now if the difference in nighttime reflux between the different GERD groups is related to the distribution of intraesophageal pH level ...

    journal_title:Journal of clinical gastroenterology

    pub_type: 杂志文章


    authors: Hershcovici T,Jha LK,Fass R

    更新日期:2012-08-01 00:00:00

  • Role of Interventional Radiology in Complications of Portal Hypertension.

    abstract::Portal hypertension, a consequence of end-stage liver disease and liver cirrhosis can lead to significant morbidity and mortality for patients through abnormal fluid accumulation as well as the formation of portosystemic shunts and varices. Treatment of the sequelae of portal hypertension can be achieved through endov...

    journal_title:Journal of clinical gastroenterology

    pub_type: 杂志文章,评审


    authors: Shreve L,Lee EW

    更新日期:2019-05-01 00:00:00

  • Comparison of hepatic venous pressure gradient and two models of end-stage liver disease for predicting the survival in patients with decompensated liver cirrhosis.

    abstract:GOALS:We evaluated the efficacy of initial and follow-up hepatic venous pressure gradient (HVPG), models of end-stage liver disease (MELD), and MELD-Na for predicting the survival of patients with decompensated liver cirrhosis (LC). BACKGROUND:MELD with/without Na score and HVPG have been important predictors of morta...

    journal_title:Journal of clinical gastroenterology

    pub_type: 杂志文章


    authors: Suk KT,Kim CH,Park SH,Sung HT,Choi JY,Han KH,Hong SH,Kim DY,Yoon JH,Kim YS,Baik GH,Kim JB,Kim DJ

    更新日期:2012-11-01 00:00:00

  • Follow-up care after a diagnosis of Helicobacter pylori infection in an Asian immigrant cohort.

    abstract:GOAL:To study the rate at which Helicobacter pylori infection is treated in an immigrant cohort after diagnosis by esophagogastroduodenoscopy (EGD). BACKGROUND:Gastric cancer is the second leading cause of cancer death worldwide, and is especially prevalent in East Asia; immigrants from this part of the world remain a...

    journal_title:Journal of clinical gastroenterology

    pub_type: 杂志文章,多中心研究


    authors: Cho A,Chaudhry A,Minsky-Primus L,Tso A,Perez-Perez G,Diehl DL,Marcus SG,Gany FM

    更新日期:2006-01-01 00:00:00

  • Confocal endomicroscopic examination of malignant biliary strictures and histologic correlation with lymphatics.

    abstract:BACKGROUND AND AIMS:Current methods to diagnose malignant biliary strictures are of low sensitivity. Confocal endomicroscopy is a new approach that may improve the diagnosis of indeterminate biliary strictures. The purpose of this study was to evaluate indeterminate biliary strictures using probe-based confocal laser e...

    journal_title:Journal of clinical gastroenterology

    pub_type: 杂志文章


    authors: Loeser CS,Robert ME,Mennone A,Nathanson MH,Jamidar P

    更新日期:2011-03-01 00:00:00

  • The Distribution of Gastrointestinal Pathogens on Stool PCR Prior to the Development of IBD.

    abstract:GOALS:We investigated the distribution of pathogens on stool gastrointestinal (GI) polymerase chain reaction (PCR) testing in those who subsequently developed inflammatory bowel disease (IBD). BACKGROUND:Infectious gastroenteritis has been associated with later development of IBD. STUDY:This retrospective study inclu...

    journal_title:Journal of clinical gastroenterology

    pub_type: 杂志文章


    authors: Varma S,Green PH,Krishnareddy S

    更新日期:2020-11-25 00:00:00

  • Modified barium swallow does not affect how often PEGs are placed after stroke.

    abstract::Dysphagia frequently follows stroke, but often resolves quickly. Percutaneous endoscopic gastrostomy (PEG) or other feeding tubes are placed to improve nutrition and hydration, and reduce the risk of aspiration pneumonitis. We evaluated the impact of modified barium swallow in determining PEG placements and the influe...

    journal_title:Journal of clinical gastroenterology

    pub_type: 杂志文章


    authors: Akpunonu BE,Mutgi AB,Roberts C,Khuder SA,Federman DJ,Lee L

    更新日期:1997-03-01 00:00:00

  • Copper deficiency in celiac disease.

    abstract::Copper deficiency is an uncommonly reported complication of celiac disease that has not received much attention in recent years. Copper deficiency may result in anemia and thrombocytopenia and also irreversible myeloneuropathy if it is not detected and treated appropriately. The prevalence of copper deficiency in pati...

    journal_title:Journal of clinical gastroenterology

    pub_type: 杂志文章


    authors: Halfdanarson TR,Kumar N,Hogan WJ,Murray JA

    更新日期:2009-02-01 00:00:00

  • Autoantibodies in the diagnosis and management of liver disease.

    abstract::Autoantibodies are nonpathogenic manifestations of immune reactivity, and they may occur in acute and chronic liver diseases. Autoantibodies may be consequences rather than causes of the liver injury, and they should be regarded as diagnostic clues rather than etiologic markers. Conventional autoantibodies used in the...

    journal_title:Journal of clinical gastroenterology

    pub_type: 杂志文章,评审


    authors: Czaja AJ,Norman GL

    更新日期:2003-10-01 00:00:00

  • Pneumatosis cystoides intestinalis in AIDS-associated cryptosporidiosis. More than an incidental finding?

    abstract::A 34-year-old man with acquired immunodeficiency syndrome (AIDS) developed pneumatosis cystoides intestinalis associated with an intestinal infection with Cryptosporidium organisms. The pneumatosis resolved upon treatment of the cryptosporidiosis with paromomycin and clofazimine. Four other cases of benign pneumatosis...

    journal_title:Journal of clinical gastroenterology

    pub_type: 杂志文章


    authors: Samson VE,Brown WR

    更新日期:1996-06-01 00:00:00

  • Combination therapies with a proton pump inhibitor for Helicobacter pylori-infected gastric ulcer patients.

    abstract::We investigated the eradication and recurrence rate of Helicobacter pylori-infected gastric ulcer patients by combination therapies. Eighty-six H. pylori-positive gastric ulcer patients were assigned randomly to one of seven groups: I, omeprazole 20 mg (n = 9); II, lansoprazole (LPZ) 30 mg (n = 16); III, LPZ 30 mg plu...

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    authors: Fukuda Y,Yamamoto I,Okui M,Tonokatsu Y,Shimoyama T

    更新日期:1995-01-01 00:00:00

  • Pathology of indeterminate colitis.

    abstract::The term indeterminate colitis (IC) is an interim, or preliminary, descriptive term used by pathologists for cases of inflammatory bowel disease (IBD) in which a definite diagnosis of ulcerative colitis (UC) or Crohn's disease (CD) cannot be established based on the information available at the time of surgical sign-o...

    journal_title:Journal of clinical gastroenterology

    pub_type: 杂志文章


    authors: Odze RD

    更新日期:2004-05-01 00:00:00

  • Comparative Efficacy of Drugs for the Treatment of Chronic Constipation: Quantitative Information for Medication Guidelines.

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    journal_title:Journal of clinical gastroenterology

    pub_type: 杂志文章


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    journal_title:Journal of clinical gastroenterology

    pub_type: 杂志文章


    authors: Guth AA,Pachter HL,Albanese C,Kim U

    更新日期:1994-12-01 00:00:00