The rate of liver cancer diagnoses in the United States increases with age. As of 2021, those aged 75 to 79 years had the highest rates of liver cancer. Risk factors for liver cancer include smoking, drinking alcohol, being overweight or obese, and having diabetes. Who is most likely to get liver cancer? Liver cancer in the United States is much more common among men than women. In 2021, there were 12.3 new liver cancer diagnoses among men per 100,000 population, compared to just five new diagnoses per 100,000 women. Concerning race and ethnicity, non-Hispanic American Indians and Alaska Natives and Hispanic have the highest rates of new liver cancer diagnoses. The five-year survival rate for liver cancer in the United States is around 22 percent, however, this rate is much higher among non-Hispanic Asian and Pacific Islanders than other races and ethnicities. Non-Hispanic Asian and Pacific Islanders have a 33 percent chance of surviving the next five years after a liver cancer diagnosis. Deaths from liver cancer In 2020, there were an estimated 20,262 deaths in the United States due to liver cancer. However, the death rate for liver cancer has decreased over the past few years. In the period 1999 to 2020, the death rate for liver cancer reached a high of five deaths per 100,000 population in 2015 but dropped to 4.6 deaths per 100,000 population by 2020. It is estimated that in 2024, there will be over 19,000 liver and intrahepatic bile duct cancer deaths among men in the United States and 10,700 such deaths among women.

In 2021, there were over *** thousand registrations of newly diagnosed liver cancer in England. With a total of *** cases in this year, the age group most affected by liver cancer in terms of number of cases was that of 70 to 74 year old men. It should of course be noted that the number of people in England in each age group varies and is therefore not necessarily a reflection of susceptibility to liver cancer.

Primary liver cancer is a significant global health issue, characterized by high incidence and mortality rates worldwide. Accurate diagnosis and classification of subtypes are essential for selecting appropriate treatment options and enhancing patient outcomes. Contrast-enhanced computed tomography (CECT) has proven highly sensitive and specific in diagnosing liver cancer. Currently, publicly available datasets of liver cancer CECT scans are limited and often do not comprehensively cover liver cancer subtypes or include complete phasing of CT scans. We hypothesize that utilizing full-phase 3D CECT images, including the Plain, Arterial, Venous, and Delayed phases, can improve the diagnostic classification performance for liver cancer. To test this hypothesis, we have collected a large dataset from a single medical institution that includes 278 cases of liver cancer, featuring Hepatocellular Carcinoma (HCC), Intrahepatic Cholangiocarcinoma (ICC), and Combined Hepatocellular-Cholangiocarcinoma (cHCC-CCA), as well as CECT images from 83 non-liver cancer subjects. For each patient, we annotated the liver and lesion regions. This dataset, rich in liver cancer types and complete in CT phasing, facilitates the development and validation of diagnostic classification models and lesion segmentation models tailored to liver cancer CT imaging.The median age of participants was 59 years 51, 67, with 185 males (67.3% of the liver cancer group) . Each patient had complete 3D contrast-enhanced CT (CECT) data across the Plain, Arterial, Venous, and Delayed phases, stored as NIFTI files. A total of 50,560 slices containing lesions were collected, with a median lesion volume of 75.37 cm³ [26.70, 239.24] . The Python code for loading and processing the data can be found on GitHub (https://github.com/ljwa2323/PLC_CECT).

IntroductionLiver cancer is the fastest increasing cancer in the United States and is one of the leading causes of cancer-related death in New York City (NYC), with wide disparities among neighborhoods. The purpose of this cross-sectional study was to describe liver cancer incidence by neighborhood and examine its association with risk factors. This information can inform preventive and treatment interventions.Materials and methodsPublicly available data were collected on adult NYC residents (n = 6,407,022). Age-adjusted data on liver and intrahepatic bile duct cancer came from the New York State Cancer Registry (1) (2007–2011 average annual incidence); and the NYC Vital Statistics Bureau (2015, mortality). Data on liver cancer risk factors (2012–2015) were sourced from the New York City Department of Health and Mental Hygiene: (1) Community Health Survey, (2) A1C registry, and (3) NYC Health Department Hepatitis surveillance data. They included prevalence of obesity, diabetes, diabetic control, alcohol-related hospitalizations or emergency department visits, hepatitis B and C rates, hepatitis B vaccine coverage, and injecting drug use.ResultsLiver cancer incidence in NYC was strongly associated with neighborhood poverty after adjusting for race/ethnicity (β = 0.0217, p = 0.013); and with infection risk scores (β = 0.0389, 95% CI = 0.0088–0.069, p = 0.011), particularly in the poorest neighborhoods (β = 0.1207, 95% CI = 0.0147–0.2267, p = 0.026). Some neighborhoods with high hepatitis rates do not have a proportionate number of hepatitis prevention services.ConclusionHigh liver cancer incidence is strongly associated with infection risk factors in NYC. There are gaps in hepatitis prevention services like syringe exchange and vaccination that should be addressed. The role of alcohol and metabolic risk factors on liver cancer in NYC warrants further study.

This record contains raw data related to article “Incidence and predictors of hepatocellular carcinoma in patients with autoimmune hepatitis"

Abstract

Background and aims: Autoimmune hepatitis (AIH) is a rare chronic liver disease of unknown aetiology; the risk of hepatocellular carcinoma (HCC) remains unclear and risk factors are not well-defined. We aimed to investigate the risk of HCC across a multicentre AIH cohort and to identify predictive factors.

Methods: We performed a retrospective, observational, multicentric study of patients included in the International Autoimmune Hepatitis Group Retrospective Registry. The assessed clinical outcomes were HCC development, liver transplantation, and death. Fine and Gray regression analysis stratified by centre was applied to determine the effects of individual covariates; the cumulative incidence of HCC was estimated using the competing risk method with death as a competing risk.

Results: A total of 1,428 patients diagnosed with AIH from 1980 to 2020 from 22 eligible centres across Europe and Canada were included, with a median follow-up of 11.1 years (interquartile range 5.2-15.9). Two hundred and ninety-three (20.5%) patients had cirrhosis at diagnosis. During follow-up, 24 patients developed HCC (1.7%), an incidence rate of 1.44 cases/1,000 patient-years; the cumulative incidence of HCC increased over time (0.6% at 5 years, 0.9% at 10 years, 2.7% at 20 years, and 6.6% at 30 years of follow-up). Patients who developed cirrhosis during follow-up had a significantly higher incidence of HCC. The cumulative incidence of HCC was 2.6%, 4.6%, 5.6% and 6.6% at 5, 10, 15, and 20 years after the development of cirrhosis, respectively. Obesity (hazard ratio [HR] 2.94, p = 0.04), cirrhosis (HR 3.17, p = 0.01), and AIH/PSC variant syndrome (HR 5.18, p = 0.007) at baseline were independent risk factors for HCC development.

Conclusions: HCC incidence in AIH is low even after cirrhosis development and is associated with risk factors including obesity, cirrhosis, and AIH/PSC variant syndrome.

Impact and implications: The risk of developing hepatocellular carcinoma (HCC) in individuals with autoimmune hepatitis (AIH) seems to be lower than for other aetiologies of chronic liver disease. Yet, solid data for this specific patient group remain elusive, given that most of the existing evidence comes from small, single-centre studies. In our study, we found that HCC incidence in patients with AIH is low even after the onset of cirrhosis. Additionally, factors such as advanced age, obesity, cirrhosis, alcohol consumption, and the presence of the AIH/PSC variant syndrome at the time of AIH diagnosis are linked to a higher risk of HCC. Based on these findings, there seems to be merit in adopting a specialized HCC monitoring programme for patients with AIH based on their individual risk factors.

Background: Liver cancer is one of the leading causes of cancer-related deaths worldwide. The primary causes of liver cancer include hepatitis B virus (HBV), hepatitis C virus (HCV), alcohol consumption, nonalcoholic fatty liver disease, and other factors. Aims: The objective of this study was to evaluate the global and sex-, age-, region-, country-, and etiology-related liver cancer burden, as well as the trends in liver cancer caused by different etiologies. Methods: The causes of liver cancer from 1990 to 2017, including global, regional, and national liver cancer incidence, mortality, and etiology, were collected from the Global Burden of Disease study 2017, and the time-dependent change in the trends of liver cancer burden was evaluated by annual percentage change. Results: The global liver cancer incidence and mortality have been increasing. There were 950,000 newly-diagnosed liver cancer cases and over 800,000 deaths in 2017, which is more than twice the numbers recorded in 1990. HBV and HCV are the major causes of liver cancer. HBV is the major risk factor of liver cancer in Asia, while HCV and alcohol abuse are the major risk factors in the high sociodemographic index and high human development index regions. The mean onset age and incidence of liver cancer with different etiologies have gradually increased in the past 30 years. Conclusions: The global incidence is still rising and the causes have national, regional, or population specificities. More targeted prevention strategies must be developed for the different etiologic types in order to reduce liver cancer burden.

BackgroundNASH-associated liver cancer (NALC) is a significant contributor to global cancer mortality, closely linked to the increasing prevalence of non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH). This study comprehensively examines the global burden of NALC from 1990 to 2021.MethodsThis study used data from the Global Burden of Disease (GBD) 2021 database to analyze NALC death and age-standardized death rates (ASDR) globally and regionally from 1990 to 2021. We applied Joinpoint regression analysis to assess temporal trends, calculating the annual percent change (APC) and average annual percent change (AAPC). Decomposition analysis was performed to break down mortality changes into contributions from population aging, growth, and epidemiological changes. A frontier analysis was used to evaluate the relationship between NALC burden and sociodemographic development using the Socio-Demographic Index (SDI). Prediction analysis of NALC deaths and ASDR from 2021 to 2045 were estimated using the Nordpred model.ResultsFrom 1990 to 2021, the global burden of NALC deaths increased significantly, with the ASDR rising from 0.38 per 100,000 in 1990 to 0.48 per 100,000 in 2021. Age-specific data in 2021 revealed that NALC deaths peaked in the 65–69 age group for men and 70–74 age group for women. Decomposition analysis indicated that population growth was the most significant contributor to the global NALC death toll, followed by population aging and epidemiological changes. Frontier analysis showed that countries like Mongolia and Gambia were farthest from the disease burden frontier, while Morocco and Ukraine were closest. Prediction analysis suggest a significant increase in NALC deaths by 2045 compared to 2021, with a larger rise in deaths among women.ConclusionThrough this study, a data-driven approach is provided to reduce the global disease burden of NALC. Essential data support for public health prevention strategies is offered, helping guide the development of targeted government interventions. Trends across global regions, countries, age groups, and genders have been analyzed, providing valuable insights for the formulation of evidence-based policies aimed at mitigating the impact of NALC worldwide.

ObjectiveWe performed a matched cohort study among individuals with and without nonalcoholic fatty liver disease (NAFLD) to determine: 1) the incidence of cancers (extrahepatic and liver) and their spectrum and 2) if NAFLD increases the risk of extrahepatic cancers.MethodsThe NAFLD and non-NAFLD (control) cohorts were identified from electronic medical records via International Classification of Diseases (ICD) codes from a single center and followed from 2010 to 2019. Cohorts were matched 1:2 for age, sex, race, body mass index (BMI), and type 2 diabetes.ResultsA total of 1,412 subjects were included in the analyses. There were 477 individuals with NAFLD and 935 controls (median age, 52 years; women, 54%; white vs. black: 59% vs. 38%; median BMI, 30.4 kg/m2; type 2 diabetes, 34%). The cancer incidence (per 100,000 person-years) was 535 vs. 1,513 (NAFLD vs. control). Liver cancer incidence (per 100,000 person-years) was 89 in the NAFLD group vs. 0 in the control group, whereas the incidence of malignancy was higher across other types of cancer in the control group vs. in the NAFLD group.ConclusionsThe overall extrahepatic cancer risk in NAFLD is not increased above and beyond the risk from background risk factors such as age, race, sex, BMI, and type 2 diabetes.

Cancer was responsible for around 142 deaths per 100,000 population in the United States in 2022. The death rate for cancer has steadily decreased since the 1990’s, but cancer still remains the second leading cause of death in the United States. The deadliest type of cancer for both men and women is cancer of the lung and bronchus which will account for an estimated 65,790 deaths among men alone in 2024. Probability of surviving Survival rates for cancer vary significantly depending on the type of cancer. The cancers with the highest rates of survival include cancers of the thyroid, prostate, and testis, with five-year survival rates as high as 99 percent for thyroid cancer. The cancers with the lowest five-year survival rates include cancers of the pancreas, liver, and esophagus. Risk factors It is difficult to determine why one person develops cancer while another does not, but certain risk factors have been shown to increase a person’s chance of developing cancer. For example, cigarette smoking has been proven to increase the risk of developing various cancers. In fact, around 81 percent of cancers of the lung, bronchus and trachea among adults aged 30 years and older can be attributed to cigarette smoking. A recent poll indicated that many U.S. adults believed smoking cigarettes and using other tobacco products increased a person’s risk of developing cancer, but a much smaller percentage believed the same for proven risk factors such as obesity and drinking alcohol.

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Demographic Summary of Available Imaging

Characteristic	Value (N = 190)
Age (months)	Mean ± SD: 25.3 ± 29 Median (IQR): 17 (10-30.2) Range: 0-189
Sex	Male: 120 (63%) Female: 70 (37%)
Race	Not Available
Ethnicity	Not Available

This collection contains data from the National Cancer Institute Clinical Trial NCT00980460, "Risk-Based Therapy in Treating Younger Patients With Newly Diagnosed Liver Cancer." It was sponsored by NCI's Children’s Oncology Group (COG) under study number AHEP0731. This phase III trial studies the side effects and how well risk-based therapy works in treating younger patients with newly diagnosed liver cancer. Select individual patient-level data from this trial can be requested from the NCTN/NCORP Data Archive.

Trial Description

Surgery, chemotherapy drugs (cancer fighting medicines), and when necessary, liver transplant, are the main current treatments for hepatoblastoma. The stage of the cancer is one factor used to decide the best treatment. Treating patients according to the risk group they are in may help get rid of the cancer, keep it from coming back, and decrease the side effects of chemotherapy.

Hepatoblastoma treatment with curative intent requires surgical resection, but only about a third of newly diagnosed patients with hepatoblastoma have resectable disease at diagnosis. Patients who have upfront resection typically receive a total of 4–6 cycles of adjuvant chemotherapy post-surgery, with the combination of cisplatin, fluorouracil, and vincristine. The aim is to investigate whether event-free survival in children with hepatoblastoma who had complete resection at diagnosis could be maintained with two cycles of adjuvant chemotherapy. This multicentre, phase 3 trial was designed to test a risk-based treatment approach for children with hepatoblastoma, to diminish toxicity in low-risk patients, improve survival in intermediate-risk patients, and identify new agents that may be used in high-risk and recurrent patients. Patients were staged for risk classification using the Children’s Oncology Group staging guidelines before the initiation of chemotherapy, with stage IV indicating metastatic disease. Pretreatment extent of disease (PRETEXT) grouping also was performed at the time of diagnosis and with any subsequent abdominal computed tomography or magnetic resonance imaging and was used to guide the surgical management but was not used for risk classification. The response rate and outcome to the combination of vincristine and irinotecan administered in an upfront window to children newly diagnosed with high-risk hepatoblastoma was determined.

For Low-Risk patients CT chest was used for metastatic tumor response assessment. Abdominal Ultrasound was obtained at baseline. For Intermediate- and High-Risk patients abdominal ultrasound, CT and/or MRI was used for primary tumor response assessment and CT chest for metastatic tumor response assessment.

Trial Outcomes

Results of the trial for Low-Risk patients have been reported in the following publication:

Katzenstein, H. M., Langham, M. R., Malogolowkin, M. H., Krailo, M. D., Towbin, A. J., McCarville, M. B., Finegold, M. J., Ranganathan, S., Dunn, S., McGahren, E. D., Tiao, G. M., O’Neill, A. F., Qayed, M., Furman, W. L., Xia, C., Rodriguez-Galindo, C., & Meyers, R. L. (2019). Minimal adjuvant chemotherapy for children with hepatoblastoma resected at diagnosis (AHEP0731): a Children’s Oncology Group, multicentre, phase 3 trial. The Lancet Oncology, 20(5), 719–727. DOI: https://doi.org/10.1016/s1470-2045(18)30895-7. Epub 2019 Apr 8. Erratum in: Lancet Oncol. 2019 May;20(5):e243. PMID: 30975630; PMCID: PMC6499702. Epub 2019 Apr 8. Erratum in: Lancet Oncol. 2019 May;20(5):e243. PMID: 30975630; PMCID: PMC6499702.

Cumulative hepatocellular carcinoma incidence (%) in subgroups by age, sex, cirrhosis, diabetes mellitus, or other non-hepatic events.

Nonalcoholic steatohepatitis (NASH) is related to metabolic dysregulation and the perturbation of endoplasmic reticulum (ER) homeostasis that frequently develops into hepatocellular carcinoma (HCC). Gp78 is E3 ligase, which regulates endoplasmic reticulum-associated degradation (ERAD) by ubiquitinylation of misfolded ER proteins. Here, we report that upon ageing (12 months), gp78-/- mice developed obesity, recapitulating age-related human NASH. Liver histology of gp78-/- mice revealed typical steatosis, hepatic inflammation and fibrosis, followed by progression to hepatocellular tumors. Acute ER stress revealed that loss of gp78 results in up regulation of unfolded protein response (UPR) pathways and SREBP-1 regulating de novo lipogenesis, responsible for fatty liver. Tissue array of human hepatocellular carcinoma (HCC) demonstrated that the expression of gp78 was inversely correlated with clinical grades of cancer. Here, we have described the generation of the first preclinical experimental model system which spontaneously develops age-related NASH and HCC, linking ERAD to hepatosteatosis, cirrhosis, and cancer. It suggests that gp78 is a regulator of normal liver homeostasis and a tumor suppressor in human liver.

Introduction: Hepatocellular carcinoma (HCC) accounts for nearly 90% of primary liver cancers, with estimates of over 1 million people affected by 2025. We aimed to explore the impacting role of an iterative surgical treatment approach in a cohort of HCC patients within the Milan criteria, associated with clinical risk factors for tumor recurrence (RHCC) after liver transplant (LT) and loco-regional therapies (LRT), as well as liver resection (LR) and/or microwave thermal ablation (MWTA).

Methods: We retrospectively analyzed our experience performed during an 8-year period between January 2013 and December 2021 in patients treated for HCC, focusing on describing the impact on preoperative end-stage liver disease severity, oncologic staging, tumor characteristics, and surgical treatments. The Cox model was used to evaluate variables that could predict relapse risks. Relapse risk curves were calculated according to the Kaplan-Meier method, and the log-rank test was used to compare them.

Results: There were 557 HCC patients treated with a first-line approach of LR and/or LRTs (n = 335) or LT (n = 222). The median age at initial transplantation was 59 versus 68 for those whose first surgical approach was LR and/or LRT. In univariate analysis with the Cox model, nodule size was the single predictor of recurrence of HCC in the posttreatment setting (HR: 1.61, 95% CI: 1.05-2.47, p = 0.030). For the LRT group, we have enlightened the following clinical characteristics as significantly associated with RHCC: hepatitis B virus infection (which has a protective role with HR: 0.34, 95% CI: 0.13-0.94, p = 0.038), number of HCC nodules (HR: 1.54, 95% CI: 1.22-1.94, p < 0.001), size of the largest nodule (HR: 1.06, 95% CI: 1.01-1.12, p = 0.023), serum bilirubin (HR: 1.57, 95% CI: 1.03-2.40, p = 0.038), and international normalized ratio (HR: 16.40, 95% CI: 2.30-118.0, p = 0.006). Among the overall 111 patients with RHCC in the LRT group, 33 were iteratively treated with further curative treatment (12 were treated with LR, two with MWTA, three with a combined LR-MWTA treatment, and 16 underwent LT). Only one of 18 recurrent patients previously treated with LT underwent LR. For these RHCC patients, multivariable analysis showed the protective roles of LT for primary RHCC after IDLS (HR: 0.06, 95% CI: 0.01-0.36, p = 0.002), of the time relapsed between the first and second IDLS treatments (HR: 0.97, 95% CI: 0.94-0.99, p = 0.044), and the impact of previous minimally invasive treatment (HR: 0.28, 95% CI: 0.08-1.00, p = 0.051).

Conclusion: The coexistence of RHCC with underlying cirrhosis increases the complexity of assessing the net health benefit of ILDS before LT. Minimally invasive surgical therapies and time to HCC relapse should be considered an outcome in randomized clinical trials because they have a relevant impact on tumor-free survival.

This record contains raw data related to article "Liver metastases from colorectal cancer: propensity score-based comparison of stereotactic body radiation therapy vs. microwave ablation"

PURPOSE:

The study aim was to compare the disease control in two groups of patients affected by liver metastases from CRC treated with microwave ablation (MWA) or stereotactic body radiation therapy (SBRT).

METHODS:

We extracted data of patients treated between 2009 and 2016. Inclusion criteria were: (1) maximum diameter of the liver lesions less than 4 cm; (2) no more than three liver lesions; (3) no evidence of progressive or untreated gross disease outside the liver; (4) adequate liver function; (5) no concurrent chemotherapy; (6) minimum age of 18. Tumour response was classified according to EORTC-RECIST criteria. Aim of the present study was to evaluate freedom from local progression (FFLP). To reduce indication bias, an inverse probability of treatment weighting was used to estimate treatment effect.

RESULTS:

A total of 135 patients with 214 lesions were included in the analysis. Median follow-up time was 24.5 months (range 2.4-95.8). The 1-year freedom from local progression (FFLP) was 88% (95%CI 80-92). In the SBRT group, FFLP was statistically longer than MWA group (p = 0.0214); the 1-year FFLP was 91% (95% CI 81-95) in SBRT group and 84% (95% CI 0.72-0.91) in MWA group. Patients treated with SBRT showed a reduce risk of local relapse compared to MWA (adjusted HR 0.31; 95%CI 0.13-0.70, p = 0.005). As expected, analogous result obtained in the inverse probability weighting analysis (HR 0.38; 95%CI 0.18-0.80; p = 0.011).

CONCLUSION:

In conclusion, there seems to be an advantage of SBRT compared to MWA in treating CRC liver metastases, particularly for lesions bigger than 30 mm.

The annexes A to E to the Scientific Opinion on Aflatoxins in Food included in the upload are excel files as follows:

• Annex A: Dietary surveys per country and age group available in the EFSA Comprehensive Database, considered in the exposure assessment
• Annex B: Occurrence data on aflatoxins
• Annex C: Proportion of left-censored data and the mean concentrations of the quantified analytical results of AFB1 for pistachios, hazelnuts, peanuts, other nuts and dried figs
• Annex D: AFB1 and AFM1 concentrations reported for organic farming and conventional farming in selected food categories
• Annex E: Mean and high chronic dietary exposure to aflatoxins per survey and the contribution of different food groups to the dietary exposure

In 2024, California had the highest number of liver transplants performed among all U.S. states. That year, there were around 1,243 liver transplants performed in California. The state with the second-highest number of liver transplants was Texas. Liver transplants are the second most common transplant in the United States, behind kidney transplants. Liver transplants in the United States In 2023, there were just over 10,660 liver transplants carried out in the United States. Most liver transplants in the U.S. are among adults aged 50 to 64 years, with this age group accounting for around 43 percent of all liver transplants. The current need for liver transplants exceeds availability, with over nine thousand people in the United States waiting to receive a liver transplant. Liver transplantation is a treatment option for those suffering from end-stage chronic liver disease, in which the liver is damaged beyond repair. Liver disease End-stage chronic liver disease, or liver failure, has various causes including cirrhosis, hepatitis B and C, and liver cancer. Around half of all deaths in the United States caused by liver cirrhosis are related to alcohol use. Liver cirrhosis is scarring of the liver because of long-term damage. The death rate due to alcohol-related cirrhosis in the United States has increased over the past couple decades. Men are much more likely to die from liver cirrhosis than women.

This record contains raw data related to article "Stereotactic Body Radiation Therapy for Lung and Liver Oligometastases from Breast Cancer: Toxicity Data of a Prospective Non-Randomized Phase II Trial" Abstract Aims: We report the mature toxicity data of a phase II non-randomized trial on the use of SBRT for lung and liver oligometastases. Methods: Oligometastatic patients from breast cancer were treated with SBRT for up to five lung and/or liver lesions. Inclusion criteria were: age > 18 years, ECOG 0-2, diagnosis of breast cancer, less than five lung/liver lesions (with a maximum diameter <5 cm), metastatic disease confined to the lungs and liver or extrapulmonary or extrahepatic disease stable or responding to systemic therapy. Various dose-fractionation schedules were used. Then, a 4D-CT scan and FDG-CTPET were acquired for simulation and fused for target definition. Results: From 2015 to 2021, 64 patients and a total of 90 lesions were irradiated. Treatment was well tolerated, with no G 3-4 toxicities. No grade ≥3 toxicities were registered and the coprimary endpoint of the study was met. Median follow-up was 19.4 months (range 2.6-73.1). Conclusions: The co-primary endpoint of this phase II trial was met, showing excellent tolerability of SBRT for lung and liver oligometastatic in breast cancer patients. Until efficacy data will mature with longer follow-up, SBRT should be regarded as an opportunity for oligometastatic breast cancer patients.

Background: Liver resection (LR) remains the best therapeutic option for patients with early-stage hepatocellular carcinoma (HCC) with preserved hepatic function and who are not eligible for liver transplantation. After its inception, the enhanced recovery after surgery (ERAS) protocol was widely used for treating patients with liver cancer, although there are still no clear indications for improving upon it in both open and laparoscopic surgery.

Objective: This study aims to describe our institute's experience in the application of the ERAS protocol in a cohort of HCC patients, and to explore possible factors that could have an impact on postoperative outcomes.

Materials and Methods: We retrospectively analyzed our experience with LR performed from September 2017 to January 2020 in patients treated with ERAS protocol, focusing on describing impact on postoperative nutrition, analgesic requirements, and length of hospitalization. Demographics, operative factors, and postoperative complications of patients were reviewed.

Results: During the study period, 89 HCC patients were eligible for LR, and 75% of patients presented with liver cirrhosis. The most prevalent among etiologic factors was hepatitis C virus infection (53 patients out of 89, 60%), followed by nonalcoholic steatohepatitis (18 patients, 20%). The median age was 70 years. Liver cirrhosis did not have an impact on postoperative course of patients. Patients who underwent laparoscopic surgery and nonanatomic LR experienced low complication rates, shorter length of stay, and shorter time of intravenous analgesic requirements.

Conclusions: Continual refinement with ERAS protocol for treating HCC patients based on perioperative counseling and surgical decision-making is crucial to guarantee low complication rates, and reduce patient morbidity and time for recovery.

BackgroundThe clinical characteristics of primary liver cancer (PLC) patients are changing, maybe due to hepatitis viral vaccination and lifestyle changes, etc. The linkage between these changes and outcomes among these PLCs has not yet been fully elucidated.MethodsIt was identified total of 1691 PLC cases diagnosed between 2000 ~ 2020. Cox proportional hazards models were utilized to determine the connections between the clinical presentations and their close risk factor(s) from PLC patients.ResultsThe average age of PLC patients increased gradually from 52.74 ± 0.5 years in 2000 ~ 2004 to 58.63 ± 0.44 years in 2017 ~ 2020, accompanied by an increased proportion of females from 11.11% to 22.46%, and non-viral hepatitis-related PLC was raised from 1.5% to 22.35%. 840 (49.67%) PLC patients with alpha-fetoprotein (AFP) < 20ng/mL (AFP-negative). The mortality was 285 (16.85%) or 532 (31.46%) PLC patients with alanine transaminase (ALT) between 40 ~ 60 IU/L or ALT > 60 IU/L. The PLC patients with pre-diabetes/diabetes or dyslipidemia also increased from 4.29% or 11.1% in 2000 ~ 2004 to 22.34% or 46.83% in 2017 ~ 2020. The survival period of the PLC patients with normoglycemia or normolipidemic was 2.18 or 3.14 folds longer than those patients with pre-diabetes/diabetes or hyperlipidemia (P

Data by medical encounter for the following conditions by age, race/ethnicity, and gender:

Acute Myocardial Infarction (AMI)
Asthma
Bladder Cancer
Brain Cancer
Coronary Heart Disease (CHD)
Colorectal Cancer
Chronic Obstructive Pulmonary Disease (COPD)/Chronic Lower Respiratory Diseases
Diabetes
Female Breast Cancer
Female Reproductive Cancer
Heart Failure
Hyperlipidemia (High Blood Cholesterol)
Kidney Cancer
Leukemia
Liver Cancer Lung Cancer Lupus and Connective Tissue Disorders
Melanoma of the Skin
Non-Hodgkin's Lymphoma
Non-melanoma Skin Cancer
Overall Cancer
Overall Heart Disease
Overall Hypertensive Diseases
Pancreatic Cancer
Prostate Cancer Stroke
Thyroid Cancer

Rates per 100,000 population. Age-adjusted rates per 100,000 2000 US standard population.
Blank Cells: Rates not calculated for fewer than 11 events. Rates not calculated in cases where zip code is unknown. Geography not reported where there are no cases reported in a given year. SES: Is the median household income by SRA community. Data for SRAs only.
*The COVID-19 pandemic was associated with increases in all-cause mortality. COVID-19 deaths have affected the patterns of mortality including those of Non-Communicable conditions.

Data sources: California Department of Public Health, Center for Health Statistics, Office of Health Information and Research, Vital Records Business Intelligence System (VRBIS). California Department of Health Care Access and Information (HCAI), Emergency Department Database and Patient Discharge Database, 2020. SANDAG Population Estimates, 2020 (vintage: 09/2022). Population estimates were derived using the 2010 Census and data should be considered preliminary. Prepared by: County of San Diego, Health and Human Services Agency, Public Health Services, Community Health Statistics Unit, February 2023.