Dataset Information

Hepatocellular carcinoma in olmsted county, Minnesota, 1976-2008.

ABSTRACT:

Objective

To analyze longitudinal trends in the incidence, etiology, and treatment of hepatocellular carcinoma (HCC) in community residents in Olmsted County, Minnesota, and their survival.

Patients and methods

Olmsted County residents 20 years or older with HCC newly diagnosed from January 1, 1976, through December 31, 2008, were identified using a community-wide medical record linkage system (Rochester Epidemiology Project). The incidence rate of HCC was calculated by age and sex according to the 2000 US Census population. Temporal trends of HCC etiology, treatment, and patient survival were assessed.

Results

The age- and sex-adjusted incidence rate for HCC in Olmsted County was 3.5 per 100,000 person-years for the first era (1976-1990), 3.8 per 100,000 for the second era (1991-2000), and 6.9 per 100,000 for the third era (2001-2008). Alcohol use was the most common risk factor in the first and second eras and chronic hepatitis C virus in the third. The proportion attributed to nonalcoholic fatty liver disease was small (5/47 [10.6%] in the third era). Because the proportion of patients receiving curative treatment increased over time, survival also improved, with a median survival time of 3, 6, and 9 months in the first, second, and third eras, respectively (P=.01).

Conclusion

In this midwestern US community, the incidence of HCC has increased, primarily due to hepatitis C virus. Although there was a demonstrable improvement in the outcome of HCC in community residents over time, the overall prognosis remains poor.

SUBMITTER: Yang JD

PROVIDER: S-EPMC3538386 | biostudies-literature | 2012 Jan

REPOSITORIES: biostudies-literature

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Publications

Hepatocellular carcinoma in olmsted county, Minnesota, 1976-2008.

Yang Ju Dong JD Kim Bohyun B Sanderson Schuyler O SO St Sauver Jennifer L JL Yawn Barbara P BP Pedersen Rachel A RA Larson Joseph J JJ Therneau Terry M TM Roberts Lewis R LR Kim W Ray WR

Mayo Clinic proceedings 20120101 1

<h4>Objective</h4>To analyze longitudinal trends in the incidence, etiology, and treatment of hepatocellular carcinoma (HCC) in community residents in Olmsted County, Minnesota, and their survival.<h4>Patients and methods</h4>Olmsted County residents 20 years or older with HCC newly diagnosed from January 1, 1976, through December 31, 2008, were identified using a community-wide medical record linkage system (Rochester Epidemiology Project). The incidence rate of HCC was calculated by age and se ...[more]

PMID: 22212963

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Project description:ImportanceTrabeculectomy is the surgical standard of care for patients with medically refractory glaucoma. The use of antimetabolite agents, such as mitomycin, has increased the rate of complications after trabeculectomy.ObjectiveTo determine the rate of trabeculectomy-related complications during a 25-year study.Design, setting, and participantsFor this retrospective, population-based study, we enrolled the residents of Olmsted County, Minnesota, who underwent a trabeculectomy from January 1, 1985, through December 31, 2010, at the Mayo Clinic and Olmsted Community Hospital. Data were collected from August 2012 to September 2013 followed by data analysis through January 2014.ExposuresAfter reviewing the patient records, we determined the occurrence of complications, including bleb leak, hypotony, hyphema, choroidal effusion, choroidal hemorrhage, blebitis, and endophthalmitis, as they relate to the mitomycin concentration administered during the operation. We reviewed relevant publications in Ovid, MEDLINE, and PubMed to identify studies representative of the reported trabeculectomy complication rate.Main outcomes and measuresCumulative probabilities of short- and long-term complications, determined using the Kaplan-Meier method, and the relation to mitomycin concentration applied during trabeculectomy.ResultsIn 334 patients, 460 eyes underwent trabeculectomy (mean [SD; range] follow-up, 7.7 [5.7; 0-27.7] years). Among them, 159 eyes had complications, with early complications (<3 months) in 100 eyes and late complications (≥3 months) in 59 eyes during the follow-up. Ten eyes had an early and a late complication. The 20-year cumulative chances of early, late, or any complication were 19.7% (95% CI, 16.2%-23.6%), 26.0% (95% CI, 15.0%-36.0%), and 45.0% (95% CI, 38.0%-52.0%), respectively. The cumulative probabilities of vision-threatening complications during 20 years were 2.0% (95% CI, 0%-4.0%) for blebitis and 5.0% (95% CI, 1.0%-9.0%) for endophthalmitis. Association between the rate of trabeculectomy complications and mitomycin dose used was P = .77. In total, 98 cases (21.3%) underwent further surgical procedures related directly to the complication.Conclusions and relevanceThe rate of trabeculectomy-related complications does not appear to be associated with mitomycin use during a mean follow-up of 7.7 years. The rate of vision-threatening complications appears to be comparable to those of previous studies of shorter duration.

Project description:ObjectiveTo determine the longitudinal trends in the probability of blindness due to open-angle glaucoma (OAG) in Olmsted County, Minnesota, from 1965 to 2009.DesignRetrospective, population-based cohort study.ParticipantsAll residents of Olmsted County, Minnesota (aged ≥ 40 years) who were diagnosed with OAG between January 1, 1965, and December 31, 2000.MethodsAll available medical records of every incident case of OAG were reviewed until December 31, 2009, to identify progression to blindness, defined as visual acuity ≤ 20/200 or visual field constriction to ≤ 20°. Kaplan-Meier analysis was used to estimate the cumulative probability of glaucoma-related blindness. Population incidence of blindness within 10 years of diagnosis was calculated using US Census data. Rates for subjects diagnosed in the period 1965-1980 were compared with rates for subjects diagnosed in the period 1981-2000 using log-rank tests and Poisson regression models.Main outcome measuresCumulative probability of OAG-related blindness and population incidence of blindness within 10 years of diagnosis.ResultsProbability of glaucoma-related blindness in at least 1 eye at 20 years decreased from 25.8% (95% confidence interval [CI], 18.5-32.5) for subjects diagnosed in 1965-1980 to 13.5% (95% CI, 8.8-17.9) for subjects diagnosed in 1981-2000 (P = 0.01). The population incidence of blindness within 10 years of the diagnosis decreased from 8.7 per 100,000 (95% CI, 5.9-11.5) for subjects diagnosed in 1965-1980 to 5.5 per 100,000 (95% CI, 3.9-7.2) for subjects diagnosed in 1981-2000 (P = 0.02). Higher age at diagnosis was associated with increased risk of progression to blindness (P < 0.001).ConclusionsThe 20-year probability and the population incidence of blindness due to OAG in at least 1 eye have decreased over a 45-year period from 1965 to 2009. However, a significant proportion of patients still progress to blindness despite recent diagnostic and therapeutic advancements.

Dataset Information

Hepatocellular carcinoma in olmsted county, Minnesota, 1976-2008.

Objective

Patients and methods

Results

Conclusion

Publications

Hepatocellular carcinoma in olmsted county, Minnesota, 1976-2008.

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