撒哈拉以南非洲地区肝细胞癌的管理和结局：系统评价。

The management and outcomes of hepatocellular carcinoma in sub-Saharan Africa: a systematic review.

机构信息

Department of Surgery, University of Cape Town Health Sciences Faculty, Surgical Gastroenterology Unit, Groote Schuur Hospital, Cape Town, South Africa.

出版信息

HPB (Oxford). 2024 Jan;26(1):21-33. doi: 10.1016/j.hpb.2023.09.015. Epub 2023 Sep 22.

DOI:10.1016/j.hpb.2023.09.015

PMID:37805364

Abstract

BACKGROUND

Hepatocellular carcinoma (HCC) is a leading cause of mortality in sub-Saharan Africa (SSA). This systematic review aimed to appraise all population-based studies describing the management and outcomes of HCC in SSA.

METHODS

A systematic review based on a search in PubMed, PubMed Central, Scopus, Web of Science, Cumulative Index to Nursing and Allied Health Literature (CINAHL), AfricaWide and Cochrane up to June 2023 was performed. PRISMA guidelines for systematic reviews were followed. The study protocol was registered with the International Prospective Register of Systematic Reviews (PROSPERO) (registration no: CRD42022363955).

RESULTS

Thirty-nine publications from 15 of 48 SSA countries were identified; 3989 patients were studied. The majority (74%) were male, with median ages ranging from 28 to 54 years. Chronic Hepatitis B infection was a leading aetiology and non-cirrhotic HCC was frequently reported. Curative treatment (liver resection, transplantation and ablation) was offered to 6% of the cohort. Most patients (84%) received only best supportive care (BSC), with few survivors at one year.

CONCLUSION

The majority of SSA countries do not have data reporting outcomes for HCC. Most patients receive only BSC, and curative treatment is seldom available in the region. Outcomes are poor compared to high-income countries.

摘要

背景

肝细胞癌（HCC）是撒哈拉以南非洲（SSA）地区主要的死亡原因。本系统评价旨在评估所有描述 SSA 地区 HCC 管理和结局的基于人群的研究。

方法

对截至 2023 年 6 月的 PubMed、PubMed Central、Scopus、Web of Science、护理和联合健康文献累积索引（CINAHL）、AfricaWide 和 Cochrane 进行了基于搜索的系统评价。遵循 PRISMA 系统评价指南。该研究方案已在国际前瞻性系统评价注册库（PROSPERO）（注册号：CRD42022363955）中进行了注册。

结果

从 SSA 的 48 个国家中的 15 个国家确定了 39 篇出版物；研究了 3989 名患者。大多数患者（74%）为男性，中位年龄范围为 28 至 54 岁。慢性乙型肝炎感染是主要病因，常报告非肝硬化 HCC。根治性治疗（肝切除术、移植和消融）仅在队列中的 6%的患者中提供。大多数患者（84%）仅接受最佳支持治疗（BSC），一年后仅有少数患者存活。