Academic literature on the topic 'Risk factors for HCC recurrence'

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Journal articles on the topic "Risk factors for HCC recurrence"

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Ma, Hui, Zhongchen Li, Jia Yuan, Lan Zhang, Xiaoying Xie, Xin Yin, Rongxin Chen, and Zhenggang Ren. "Extrapolating Prognostic Factors of Primary Curative Resection to Postresection Recurrences Hepatocellular Carcinoma Treatable by Radiofrequency Ablation." Gastroenterology Research and Practice 2021 (January 2, 2021): 1–7. http://dx.doi.org/10.1155/2021/8878417.

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Objective. Recurrence after curative resection for hepatocellular carcinoma (HCC) is a major cause of death from this disease. Factors of primary curative resection are available and potential in the prognosis of follow-up treatment. Our aim was to assess the prognostic significance of primary curative resection factors in recurrent HCC patients undergoing radiofrequency ablation therapy (RFA). Methods. In this retrospective study, we assessed 235 patients who underwent limited RFA of HCC recurrences ( tumors ≤ 5 cm ; nodules ≤ 3 ) after primary curative resection. Factors of primary curative resection were collected, and overall survival and recurrence-free survival were evaluated by the Kaplan-Meier method. Univariate and multivariate analyses were used to identify significant prognostic factors. Results. After a median follow-up of 36 months, 54 patients died, and 128 patients had hepatic recurrence. On univariate analyses, patients whose primary tumors were less differentiated ( p = 0.032 and p = 0.048 ) and required less time to recur ( p = 0.013 and p = 0.001 ) after curative resection displayed poorer overall survival and higher recurrence rates following RFA. On multivariate analyses, the pathologic tumor grade ( p = 0.026 and p = 0.038 ) and recurrence-free survival after primary curative resection ( p = 0.028 and p < 0.001 ) emerged as independent risk factors of survival and HCC recurrence. Conclusions. Primary tumor differentiation and time to recurrence after curative resection are viable prognostic factors of overall survival and further recurrence risk in patients undergoing RFA of recurrent HCC.
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Zhu, Yu, Lingling Gu, Ting Chen, Guoqun Zheng, Chao Ye, and Weidong Jia. "Factors influencing early recurrence of hepatocellular carcinoma after curative resection." Journal of International Medical Research 48, no. 8 (August 2020): 030006052094555. http://dx.doi.org/10.1177/0300060520945552.

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Objective To identify the factors influencing early recurrence in patients with hepatocellular carcinoma (HCC) after curative resection. Methods Clinical data for 99 patients with HCC undergoing curative resection were analyzed. The clinicopathological factors influencing early recurrence were analyzed by Cox regression. Results Twenty-five of 99 patients (25.3%) suffered from early recurrence. There were significant differences between patients with and without recurrence in terms of tumor diameter, tumor capsular integrity, and preoperative alpha fetoprotein level. Cox regression analysis revealed that a tumor diameter >2.6 cm and preoperatively increased total bilirubin (TBL) level were risk factors for postoperative recurrence, while tumor capsular integrity had a protective effect on postoperative recurrence. After adjusting for preoperative TBL level and tumor capsular integrity, the risk of HCC recurrence was markedly increased in line with increasing tumor diameter in a non-linear manner. Conclusion Tumor diameter >2.6 cm and preoperatively increased TBL level are associated with a higher risk of early recurrence after curative resection in patients with HCC, while tumor capsular integrity is associated with a lower risk of early recurrence.
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Tsai, Yung-Fong, Fu-Chao Liu, Chun-Yu Chen, Jr-Rung Lin, and Huang-Ping Yu. "Effect of Mycophenolate Mofetil Therapy on Recurrence of Hepatocellular Carcinoma after Liver Transplantation: A Population-Based Cohort Study." Journal of Clinical Medicine 10, no. 8 (April 7, 2021): 1558. http://dx.doi.org/10.3390/jcm10081558.

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Hepatocellular carcinoma (HCC) recurrence after liver transplantation is associated with immunosuppressants. However, the appropriate immunosuppressant for HCC recipients is still debated. Data for this nationwide population-based cohort study were extracted from the National Health Insurance Research Database of Taiwan. A total of 1250 liver transplant recipients (LTRs) with HCC were included. We analyzed the risk factors for post-transplant HCC recurrences. Cumulative defined daily dose (cDDD) represented the exposure duration and was calculated as the amount of dispensed defined daily dose (DDD) of mycophenolate mofetil (MMF). The dosage effects of MMF on HCC recurrence and liver graft complication rates were investigated. A total of 155 LTRs, having experienced post-transplant HCC recurrence, exhibited low survival probability at 1-, 3-, 5-, and 10-year observations. Our results demonstrated increased HCC recurrence rate after liver transplantation (p = 0.0316) following MMF administration; however, no significant increase was demonstrated following cyclosporine, tacrolimus, or sirolimus administration. Notably, our data demonstrated significantly increased HCC recurrence rate following MMF administration with cDDD > 0.4893 compared with cDDD ≤ 0.4893 or no administration of MMF (p < 0.0001). MMF administration significantly increases the risk of HCC recurrence. Moreover, a MMF-minimizing strategy (cDDD ≤ 0.4893) is recommended for recurrence-free survival.
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Grasso, Alessandro, Alberto Quaglia, Paolo Montalto, Amar P. Dhillon, David Patch, Brian Davidson, Keith Rolles, et al. "HCC and liver transplantation (LT): risk factors for recurrence." Journal of Hepatology 36 (April 2002): 80. http://dx.doi.org/10.1016/s0168-8278(02)80274-4.

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Hayashi, Michihiro, Tetsunosuke Shimizu, Fumitoshi Hirokawa, Yoshihiro Inoue, Koji Komeda, Mitsuhiro Asakuma, Yoshiharu Miyamoto, Atsushi Takeshita, Yuro Shibayama, and Nobuhiko Tanigawa. "Clinicopathological Risk Factors for Recurrence within One Year after Initial Hepatectomy for Hepatocellular Carcinoma." American Surgeon 77, no. 5 (May 2011): 572–78. http://dx.doi.org/10.1177/000313481107700516.

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Hepatocellular carcinoma (HCC) shows a high rate of recurrence after hepatectomy; predictive factors for early recurrence would help determine optimal therapeutic and management strategies. Among 163 patients with HCC undergoing hepatectomy with curative intent, 46 patients developed recurrence within 1 year. Clinicopathological data were retrospectively analyzed to identify predictive parameters for early recurrence. Survival rates in cases of recurrence within 1 year were worse than those of no recurrence within 1 year or recurrence after 1 year. Protein induced by vitamin K absence/antagonist II (PIVKA-II) greater than 150, positive fucosylated alpha-fetoprotein (L3-AFP), and deviancy from Milan criteria (MC) on preoperative imaging were associated with high risk of early recurrence and total number of these three risk factors predicted the survival. With multivariate analysis, 1) preoperatively, positive factors of two or more among three items of PIVKA-II, L3-AFP, and deviancy from MC; 2) and postoperatively, pathological cancer spread (microscopic vascular invasion and/or intrahepatic metastasis) both represented risks for early recurrence. A combination of three preoperative factors, PIVKA-II, L3-AFP, and MC status, in conjunction with the postoperative factor of cancer spread status represents a significant indicator for recurrence within 1 year. Improving the prognosis of patients with HCC would depend on how to adequately treat those at high risk of early recurrence.
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Teng, Chiao-Fang, Tsai-Chung Li, Hsi-Yuan Huang, Wen-Ling Chan, Han-Chieh Wu, Woei-Cherng Shyu, Ih-Jen Su, and Long-Bin Jeng. "Hepatitis B virus pre-S2 deletion (nucleotide 1 to 54) in plasma predicts recurrence of hepatocellular carcinoma after curative surgical resection." PLOS ONE 15, no. 11 (November 25, 2020): e0242748. http://dx.doi.org/10.1371/journal.pone.0242748.

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Hepatocellular carcinoma (HCC) is a leading cause of cancer-related death worldwide. Despite curative surgical resection, high recurrence of HCC after surgery results in poor patient survival. To develop prognostic markers is therefore important for better prevention and therapy of recurrent HCC to improve patient outcomes. Deletion mutations over the pre-S1 and pre-S2 gene segments of hepatitis B virus (HBV) have been closely associated with recurrence of HCC after curative surgical resection. In this study, we applied a next-generation sequencing-based approach to further evaluate the association of pre-S deletion regions with HCC recurrence. We demonstrated that the pre-S2 deletion (nucleotide 1 to 54) was the most predominant deletion regions of pre-S gene in plasma of HBV-related HCC patients. Moreover, patients with the pre-S2 deletion (nucleotide 1 to 54) exhibited a significantly higher risk of HCC recurrence after curative surgical resection than those without. The pre-S2 deletion (nucleotide 1 to 54) in plasma represented a prognostic factor that independently predicted HCC recurrence with greater performance than other clinicopathological and viral factors. Our data suggest that detection of the pre-S2 deletion (nucleotide 1 to 54) in plasma may be a promising noninvasive strategy for identifying patients at high risk for HCC recurrence after curative surgical resection.
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Bürger, Christin, Miriam Maschmeier, Anna Hüsing-Kabar, Christian Wilms, Michael Köhler, Martina Schmidt, Hartmut H. Schmidt, and Iyad Kabar. "Achieving Complete Remission of Hepatocellular Carcinoma: A Significant Predictor for Recurrence-Free Survival after Liver Transplantation." Canadian Journal of Gastroenterology and Hepatology 2019 (January 8, 2019): 1–7. http://dx.doi.org/10.1155/2019/5796074.

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Background. Liver transplantation (LT) is a curative treatment for hepatocellular carcinoma (HCC) and the underlying primary liver disease; however, tumor recurrence is still a major issue. Therefore, the aim of this study was to assess predictors and risk factors for HCC recurrence after LT in patients within and outside the Milan criteria with a special focus on the impact of different bridging strategies. Methods. All patients who underwent LT for HCC between 07/2002 and 09/2016 at the University Hospital of Muenster were consecutively included in this retrospective study. Database research was performed and a multivariable regression analysis was conducted to explore potential risk factors for HCC recurrence. Results. A total of 82 patients were eligible for the statistical analysis. Independent of bridging strategy, achieving complete remission (CR) was significantly associated with a lower risk for tumor recurrence (p = 0.029; OR = 0.426, 95% CI 0.198-0.918). A maximal diameter of lesion < 3 cm was also associated with lower recurrence rates (p = 0.040; OR = 0.140, 95% CI 0.022-0.914). Vascular invasion proved to be an independent risk factor for HCC recurrence (p = 0.004; OR = 11.357, 95% CI 2.142-60.199). Conclusion. Achieving CR prior to LT results in a significant risk reduction of HCC recurrence after LT independent of the treatment modalities applied.
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Yang, Jianming, Shijie Jiang, Yewu Chen, Jian Zhang, and Yinan Deng. "Adjuvant ICIs Plus Targeted Therapies Reduce HCC Recurrence after Hepatectomy in Patients with High Risk of Recurrence." Current Oncology 30, no. 2 (January 31, 2023): 1708–19. http://dx.doi.org/10.3390/curroncol30020132.

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Background: The high recurrence rate of hepatocellular carcinoma (HCC) after hepatectomy usually results in poor prognosis. To the best of our knowledge, no study has reported the efficacy of immune checkpoint inhibitors (ICIs) plus targeted therapies on preventing HCC recurrence after hepatectomy. Thus, the aim of this study was to investigate the benefits and safety of applying adjuvant ICIs plus targeted therapies after hepatectomy for patients at high risk of HCC recurrence. Methods: A total of 196 patients with any risk factors for recurrence who underwent hepatectomy for HCC were reviewed in this retrospective study. Results: Compared with the control group (n = 158), ICIs plus targeted therapies (n = 38) had a significantly higher recurrence-free survival (RFS) rate in univariate analysis (HR, 0.46; 95% confidence interval [CI], 0.24–0.90; p = 0.020), multivariate analysis (adjusted HR, 0.62; 95%CI, 0.49–0.79; p < 0.001) and propensity score-matched analysis (HR, 0.35; 95%CI, 0.16–0.75; p = 0.005). Subgroup analyses also showed that postoperative adjuvant ICIs plus targeted therapies might reduce HCC recurrence in patients with the most of risk factors. Conclusion: Postoperative adjuvant ICI plus targeted therapies may reduces early HCC recurrence in patients with a high risk of recurrence, and the treatments are well tolerated.
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Yoshizumi, Tomoharu, Toru Ikegami, Shohei Yoshiya, Takashi Motomura, Yohei Mano, Jun Muto, Rumi Matono, et al. "Impact of up-to-seven criteria and neutrophil-to-lymphocyte ratio in liver transplantation for patients who received pretreatment for hepatocellular carcinoma." Journal of Clinical Oncology 30, no. 15_suppl (May 20, 2012): e14536-e14536. http://dx.doi.org/10.1200/jco.2012.30.15_suppl.e14536.

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e14536 Background: There is currently no consensus on how to manage patients with hepatocellular carcinoma (HCC) while awaiting liver transplantation (LT). The guideline published in UK states that locoregional therapy should be considered for all listed patients with HCC. Living donor LT (LDLT) is a choice for treating HCC patients in organ shortage era. The aim of the present study is to clarify the risk factors of tumor recurrence after LDLT in patients who had received pre-transplant treatments (pre-Tx) for HCC. Methods: One hundred two adult patients (39 females and 63 males) who had undergone LDLT due to end-stage liver disease with recurrent HCC after pre-Tx were enrolled. The primary end-point of this study was HCC recurrence after LDLT. Recurrence-free survival rates after LDLT were calculated. Risk factors of tumor recurrence were identified using univariate and multivariate analysis. Results: The 1-, 3-, and 5-year recurrence-free survival rates were 89.4%, 80.7%, and 78.8%, respectively. Seventy-four of 102 patients underwent pre-Tx more than twice. Moreover, the times of pre-Tx, the interval between the first treatment and LDLT, and the interval between the last treatment and LDLT did not affect the outcome of LDLT. On univariate analysis, the factors affecting recurrence-free survival were exceeding the up-to-seven criteria (p<0.0001), exceeding the Kyushu University criteria (p<0.0001), neutrophil-to-lymphocyte ratio (NLR) > 4 (p=0.0001), Alpha-fetoprotein > 400 ng/ml (p<0.0001), and bilobar tumor distribution (p=0.047). A multivariate analysis identified independent risk factors for post-LDLT tumor recurrence were exceeding the up-to-seven criteria (p=0.001) and NLR > 4 (p=0.002). The 1- and 3-year recurrence-free survival rates in the recipients with exceeding the up-to-seven criteria and NLR > 4 were 30.0% and 15.0%, respectively. Conclusions: The kind or duration of pre-Tx did not affect the outcome of LDLT, but LDLT should not be performed for the patients with exceeding the up-to-seven criteria and NLR more than 4 after pre-Tx for HCC to prevent tumor recurrence.
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Cho, Wei-Ru, Chih-Chi Wang, Meng-Yun Tsai, Chen-Kai Chou, Yueh-Wei Liu, Yi-Ju Wu, Ming-Tsung Lin, et al. "Impact of metformin use on the recurrence of hepatocellular carcinoma after initial liver resection in diabetic patients." PLOS ONE 16, no. 3 (March 4, 2021): e0247231. http://dx.doi.org/10.1371/journal.pone.0247231.

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Background Metformin is proposed to have chemopreventive effect of various cancer currently. However, the anti-cancer effect of metformin for diabetic patients with hepatocellular carcinoma (HCC) undergoing liver resection remains unclear. The aim of our cohort study was to assess whether metformin influence the recurrence of HCC. Methods We retrospectively enrolled 857 HCC patients who received primary resection from April 2001 to June 2016. 222 patients were diagnosed with diabetes mellitus (DM) from medical record. Factors influence the overall survival (OS) and recurrence-free survival (RFS) were analyzed by multivariate analysis. Results During the follow-up period (mean, 75 months), 471 (54.9%) patients experienced recurrence, and 158 (18.4%) patients died. Multivariate analysis revealed that DM (p = 0.015), elevated AST (p = 0.006), hypoalbuminemia (p = 0.003), tumor number (p = 0.001), tumor size (p < 0.001), vascular invasion (p <0.001), high Ishak fibrosis score (p <0.001), hepatitis B (p = 0.014), hepatitis C (p = 0.001) were independent predictors for RFS. In diabetic patients, only HbA1c>9% (p = 0.033), hypoalbuminemia (p = 0.030) and vascular invasion (p = 0.001) were independent risk factors for HCC recurrence; but the metformin use revealed no significance on recurrence. DM is a risk factor of HCC recurrence after resection. Adequate DM control can reduce the recurrence of HCC. However, the use of metformin does not reduce the risk of HCC recurrence in diabetic patient after initial resection. Hence, metformin may not have protective influences on HCC recurrence in diabetic patients who undergo initial liver resection.
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Dissertations / Theses on the topic "Risk factors for HCC recurrence"

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Costa, Paulo Everton Garcia. "Risk factors for hepatocellular carcinoma recurrence after liver transplantation." Universidade Federal do CearÃ, 2014. http://www.teses.ufc.br/tde_busca/arquivo.php?codArquivo=11640.

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Hepatocellular carcinoma (HCC) is the most frequent primary liver tumor, with annual worldwide incidence of over one million cases, accounting for at least 500,000 deaths per year. The majority of cases of HCC occur in the setting of liver cirrhosis. Liver transplantation (LT) is a curative treatment modality for HCC. However the recurrence of HCC after LT is the main obstacle to the success of this treatment. The aim of this study was to evaluate the risk factors for recurrence of hepatocellular carcinoma after conducting LT. In this retrospective, descriptive and analytical study, between May 2002 and April 2012, were conducted 664 liver transplantations (LT) at HUWC â UFC, among which 140 LT were performed in patients with HCC. The risk factors of HCC recurrence after liver transplantation were analysed. The variables analyzed were: sex, age, blood type, etiology of cirrhosis, alpha-fetoprotein level, diagnostic imaging, Milan criteria, time from diagnosis of HCC and the realization of LT, time on the waiting list for the LT and pathological tumor characteristics in explant. The tumor was more frequent in men with an average age of 56 years, infected with hepatitis C virus. The rate of HCC recurrence after LT was 8, 57 % and occurred more often in the first two years after transplantation, with the liver graft being the most common site. In conclusion, independent risk factors for carcinoma hepatocellular recurrence after liver transplantation were: time in the LT waiting list above 7,8 months, liver number nodules over 3.5 nodules, tumors exceeding the Milan criteria, level of alphafetoprotein above 1000 ng/ml and presence of micro-vascular invasion.
O carcinoma hepatocelular (CHC) à o mais frequente tumor primÃrio maligno do fÃgado, com incidÃncia mundial anual de mais de um milhÃo de casos, sendo responsÃvel por pelo menos 500.000 mortes por ano. Em torno de 90 % a 95 % dos tumores estÃo associados à cirrose. O transplante hepÃtico (TH) à uma modalidade de tratamento curativo para o CHC. Entretanto, a recorrÃncia do CHC apÃs o TH à o principal obstÃculo ao sucesso deste tratamento. O objetivo deste estudo foi avaliar os fatores de risco para recorrÃncia de carcinoma hepatocelular apÃs a realizaÃÃo de TH. Foram realizados 664 transplantes de fÃgado entre maio de 2002 e abril de 2012, no Hospital UniversitÃrio Walter CantÃdio, da Universidade Federal do Cearà (HUWC â UFC), dos quais 140 casos em pacientes com diagnÃstico de CHC. Foi realizado um estudo analÃtico, descritivo, retrospectivo e longitudinal deste grupo de pacientes, analisando os fatores de risco para a recorrÃncia de CHC apÃs o TH. As variÃveis analisadas foram: sexo, idade, tipo sanguÃneo, etiologia da cirrose, nÃvel de alfa-fetoproteÃna, mÃtodos diagnÃsticos de imagem, critÃrios de MilÃo, tempo entre o diagnÃstico do CHC e a realizaÃÃo do TH, tempo em lista de espera para o TH e caracterÃsticas anatomopatolÃgicas do tumor no explante. O CHC foi mais frequente em homens com idade mÃdia de 56 anos, infectados pelo vÃrus da hepatite C. A taxa de recorrÃncia do carcinoma hepatocelular apÃs o transplante de fÃgado foi de 8,57% e ocorreu mais frequentemente nos dois primeiros anos apÃs o transplante, tendo como local mais comum o enxerto hepÃtico. Concluiu-se que o tempo de permanÃncia em lista de transplante acima de 7,8 meses, a presenÃa de mais de 3,5 nÃdulos no explante, o tumor excedendo os critÃrios de MilÃo, o nÃvel de Alfa-fetoproteÃna acima de 1000 ng/ml e a presenÃa de invasÃo microvascular sÃo fatores de risco independentes para recorrÃncia de carcinoma hepatocelular apÃs a realizaÃÃo do transplante hepÃtico.
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Knut, R. P. "Groin hernia: anatomically determined risk factors for the recurrence." Thesis, БДМУ, 2022. http://dspace.bsmu.edu.ua:8080/xmlui/handle/123456789/19674.

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Dalberg, Kristina. "Risk factors for ipsilateral breast tumor recurrence and uncontrolled local disease /." Stockholm, 1998. http://diss.kib.ki.se/search/diss.se.cfm?19981016dalb.

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West, Emily S. "Risk factors for trichiasis recurrence in a trachoma-endemic area of central Tanzania." Available to US Hopkins community, 2002. http://wwwlib.umi.com/dissertations/dlnow/3068228.

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Deshpande, Abhishek, Vinay Pasupuleti, Priyaleela Thota, Chaitanya Pant, David D. K. Rolston, Adrian V. Hernandez, Curtis J. Donskey, and Thomas G. Fraser. "Risk factors for recurrent Clostridium difficile infection: a systematic review and meta-analysis." Cambridge University Press, 2015. http://hdl.handle.net/10757/608263.

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El texto completo de este trabajo no está disponible en el Repositorio Académico UPC por restricciones de la casa editorial donde ha sido publicado.
OBJECTIVE: An estimated 20-30% of patients with primary Clostridium difficile infection (CDI) develop recurrent CDI (rCDI) within 2 weeks of completion of therapy. While the actual mechanism of recurrence remains unknown, a variety of risk factors have been suggested and studied. The aim of this systematic review and meta-analysis was to evaluate current evidence on the risk factors for rCDI. DESIGN: We searched MEDLINE and 5 other databases for subject headings and text related to rCDI. All studies investigating risk factors of rCDI in a multivariate model were eligible. Information on study design, patient population, and assessed risk factors were collected. Data were combined using a random-effects model and pooled relative risk ratios (RRs) were calculated. RESULTS: A total of 33 studies (n=18,530) met the inclusion criteria. The most frequent independent risk factors associated with rCDI were age≥65 years (risk ratio [RR], 1.63; 95% confidence interval [CI], 1.24-2.14; P=.0005), additional antibiotics during follow-up (RR, 1.76; 95% CI, 1.52-2.05; P<.00001), use of proton-pump inhibitors (PPIs) (RR, 1.58; 95% CI, 1.13-2.21; P=.008), and renal insufficiency (RR, 1.59; 95% CI, 1.14-2.23; P=.007). The risk was also greater in patients previously on fluoroquinolones (RR, 1.42; 95% CI, 1.28-1.57; P<.00001). CONCLUSIONS: Multiple risk factors are associated with the development of rCDI. Identification of modifiable risk factors and judicious use of antibiotics and PPI can play an important role in the prevention of rCDI.
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DeFeo, Graig Charles. "Risk Factors for Recurrent Major Depressive Disorder in a Nationally Representative Sample." Scholar Commons, 2014. https://scholarcommons.usf.edu/etd/5351.

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The public use version of the National Comorbidity Survey - Replication (NCS-R) dataset was used (N = 995) to investigate risk factors for recurrent major depressive disorder (MDD) that are evident before recovery from the first major depressive episode (MDE) by comparing persons diagnosed with MDD who experienced a single MDE to persons with recurrent MDD. Multiple logistic regression analyses assessed the independent risk of recurrent MDD for each of the following risk factors: an early age of onset (old), absence of a life stress trigger, chronic first episode, childhood parental loss, parental maltreatment, parental depression, comorbid anxiety disorder, and comorbid substance disorder. The relative excess risk due to interaction (RERI) assessed the risk of recurrent MDD associated with the interaction of an early onset with three childhood-based vulnerabilities: a) parental depression, b) parental loss, and c) parental maltreatment. There was a statistically significant risk of recurrent MDD found for the following risk factors: early onset, stress trigger absent, childhood parental loss, parental maltreatment, parental depression, and anxiety disorder; marginally significant results suggested an increased risk of recurrent MDD for substance disorder. There was a significant increased risk found for the interaction of an early onset with parental depression and similar non-significant trends were found for the interactions of early onset with parental loss and early onset with parental maltreatment. An early onset, the absence of a life stress trigger, and the presence of parental loss, parental maltreatment, parental depression, a comorbid anxiety disorder, and a comorbid substance disorder each confer greater risk of recurrent MDD among persons that have not yet recovered from their first lifetime MDE. The presence of an early onset combined with a childhood-based vulnerability such as parental depression, parental loss, or parental maltreatment, indicate an especially high risk of recurrent MDD. These findings may inform the development of a screening tool to assess risk for recurrent MDD and early intervention to prevent recurrent MDD. Future research should employ a longitudinal research design to replicate and expand upon these findings.
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Pennlert, Johanna. "Recurrent stroke : risk factors, predictors and prognosis." Doctoral thesis, Umeå universitet, Medicin, 2016. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-127304.

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Background Many risk factors for stroke are well characterized and might, at least to some extent, be similar for first-ever stroke and for recurrent stroke events. However, previous studies have shown heterogeneous results on predictors and rates of stroke recurrence. Patients who survive spontaneous intracerebral hemorrhage (ICH) often have compelling indications for antithrombotic (AT) treatment (antiplatelet (AP) and/or anticoagulant (AC) treatment), but due to controversy of the decision to treat, a large proportion of these patients are untreated. In the absence of evidence from randomized controlled trials (RCTs), there is need for more high- quality observational data on the clinical impact of, and optimal timing of AT in ICH survivors. The aims of this thesis were to assess time trends in stroke recurrence, to determine the factors associated with an increased risk of stroke recurrence – including socioeconomic factors – and to determine to what extent ICH survivors with and without atrial fibrillation (AF) receive AT treatment and to determine the optimal timing (if any) of such treatment.  Methods The population-based Monitoring Trends and Determinants of Cardiovascular Disease (MONICA) stroke incidence register was used to assess the epidemiology and predictors of stroke recurrence after ischemic stroke (IS) and ICH from 1995 to 2008 in northern Sweden. Riksstroke, the Swedish stroke register, linked with the National Patient Register and the Swedish Dispensed Drug Register, made it possible to identify survivors of first-ever ICH from 2005 to 2012 with and without concomitant AF to investigate to what extent these patients were prescribed AP and AC therapy. The optimal timing of initiating treatment following ICH in patients with AF 2005–2012 was described through separate cumulative incidence functions for severe thrombotic and hemorrhagic events and for the combined endpoint “vascular death or non-fatal stroke”. Riksstroke data on first-ever stroke patients from 2001 to 2012 was linked to the Longitudinal Integration Database for Health Insurance and Labour market studies to add information on education and income to investigate the relationship between socioeconomic status and risk of recurrence. Results Comparison between the cohorts of 1995–1998 and 2004–2008 showed declining risk of stroke recurrence (hazard ratio: 0.64, 95% confidence interval (CI): 0.52-0.78) in northern Sweden. Significant factors associated with an increased risk of stroke recurrence were age and diabetes. Following ICH, a majority (62%) of recurrent stroke events were ischemic.  The nationwide Riksstroke study confirmed the declining incidence, and it further concluded that low income, primary school as highest attained level of education, and living alone were associated with a higher risk of recurrence beyond the acute phase. The inverse effects of socioeconomic status on risk of recurrence did not differ between men and women and persisted over the study period. Of Swedish ICH-survivors with AF, 8.5% were prescribed AC and 36.6% AP treatment, within 6 months of ICH. In patients with AF, predictors of AC treatment were less severe ICH, younger age, previous anticoagulation, valvular disease and previous IS. High CHA2DS2-VASc scores did not seem to correlate with AC treatment. We observed both an increasing proportion of AC treatment at time of the initial ICH (8.1% in 2006 compared with 14.6% in 2012) and a secular trend of increasing AC use one year after discharge (8.3% in 2006 versus 17.2% in 2011) (p<0.001 assuming linear trends). In patients with high cardiovascular event risk, AC treatment was associated with a reduced risk of vascular death and non-fatal stroke with no significantly increased risk of severe hemorrhage. The benefit appeared to be greatest when treatment was started 7–8 weeks after ICH. For high-risk women, the total risk of vascular death or stroke recurrence within three years was 17.0% when AC treatment was initiated eight weeks after ICH and 28.6% without any antithrombotic treatment (95% CI for difference: 1.4% to 21.8%). For high-risk men, the corresponding risks were 14.3% vs. 23.6% (95% CI for difference: 0.4% to 18.2%). Conclusion Stroke recurrence is declining in Sweden, but it is still common among stroke survivors and has a severe impact on patient morbidity and mortality. Age, diabetes and low socioeconomic status are predictors of stroke recurrence. Regarding ICH survivors with concomitant AF, physicians face the clinical dilemma of balancing the risks of thrombosis and bleeding. In awaiting evidence from RCTs, our results show that AC treatment in ICH survivors with AF was initiated more frequently over the study period, which seems beneficial, particularly in high-risk patients. The optimal timing of anticoagulation following ICH in AF patients seems to be around 7–8 weeks following the hemorrhage.
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Abraham, Elizabeth C. M. D. "Focal Segmental Glomerulosclerosis in Children: An Emerging Epidemic and Risk Factors for Disease Recurrence in Transplants." University of Cincinnati / OhioLINK, 2011. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1320172013.

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Natalucci, Valentina. "Effect of exercise in Breast Cancer and its association with tumor characteristics, risk factors for recurrence and lifestyle." Doctoral thesis, Urbino, 2018. http://hdl.handle.net/11576/2663506.

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Louzada, Martha. "Evaluating Risk of Recurrent Venous Thromboembolism During the Anticoagulation Period in Patients with Malignancy." Thesis, Université d'Ottawa / University of Ottawa, 2011. http://hdl.handle.net/10393/19827.

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Background - Current guidelines suggest that all cancer patients with venous thrombosis be treated with long-term low molecular weight heparin. Whether treatment strategies should vary according to clinical characteristics remains unknown. // Systematic review - A systematic review was performed to determine current understanding of the association between malignancy characteristics in patients with cancer-associated VTE and the risk of VTE recurrence. Four retrospective and 6 prospective studies were included. They suggest that lung cancer, metastases, and adenocarcinomas confer an increased the risk of recurrence and breast cancer a low risk. // Survey - I performed survey to evaluate thrombosis experts’ opinion about the low risk of VTE recurrence they would consider acceptable for patients with cancer- associated thrombosis 103 specialists participated. 80% of respondents agreed that a risk of recurrent VTE during anticoagulation below 7% is low enough. 92% agreed that a CPR that categorizes risk of recurrence is relevant. // Retrospective Study - I performed a single retrospective cohort study to assess the feasibility of derivation of a CPR that stratifies VTE recurrence risk in patients with cancer–associated thrombosis. The study included 543 patients. A multivariate analysis selected female, lung cancer and prior history of VTE as high risk predictors and breast cancer and stage I disease as low risk. // Conclusion - Patients with cancer-associated thrombosis do have varying risks of recurrent VTE depending on clinical characteristics.
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Books on the topic "Risk factors for HCC recurrence"

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Paula, Wells, and Halstead Regina, eds. Rectal cancer: Etiology, pathogenesis and treatment. Hauppauge, NY: Nova Science Publishers, 2009.

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Bagrodia, Aditya, and Yair Lotan. Low and intermediate risk non-muscle-invasive bladder cancer. Edited by James W. F. Catto. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199659579.003.0076.

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Bladder cancer is a common disease that affects more males than females. Most bladder tumours are histologically typed as urothelial cell carcinoma, and these are best divided into cancers invading the muscularis propria and non-invasive malignancies confined to the bladder. The latter are the majority of cancers and include low risk, indolent cancers that may recur within the bladder but not progress to invasion or metastases, and a proportion that subsequently progress to muscle invasion. The risk of intravesical recurrence or progression to invasion from a non-invasive bladder cancer can be stratified as low, intermediate, and high using various pathological factors (such as tumour grade, stage, size, multiplicity, and the presence of carcinoma in situ). In this chapter, we will give an overview of bladder cancer and focus upon tumours at low or intermediate risk of developing future progression to invasion.
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Bamia, Christina, Sherri Stuver, and Lorelei Mucci. Cancer of the Liver and Biliary Tract. Oxford University Press, 2018. http://dx.doi.org/10.1093/oso/9780190676827.003.0012.

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Primary liver cancer is one of the most commonly occurring cancers globally, and is the second most common cause of cancer death worldwide. There are two major histologic forms of primary liver cancer: hepatocellular carcinoma (HCC) and cholangiocarcinoma. It is a rapidly and almost uniformly fatal disease, yet there is already sufficient knowledge about its major risk factors, many of which are modifiable, to make primary prevention effective. Primary liver cancer is one of the first common human cancer that was found to have an infectious etiology, with hepatitis B virus (HBV) and hepatitis C virus (HCV) for HCC, and parasitic liver flukes for cholangiocarcinoma. Obesity is emerging as an important risk factor, particularly in Western countries, where primary liver cancer rates appear to be increasing over time. A number of additional risk factors and potential preventive factors are considered in this chapter.
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Thomas London, W., Jessica L. Petrick, and Katherine A. McGlynn. Liver Cancer. Oxford University Press, 2017. http://dx.doi.org/10.1093/oso/9780190238667.003.0033.

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Primary liver cancer is the sixth most frequently occurring cancer in the world and the second most common in terms of cancer deaths. The global burden of liver cancer is borne principally by countries in East Asia and Africa, where 80% of liver cancer arises. Incidence rates of liver cancer, however, have begun to decline in Asia, while rates are increasing in low-rate areas such as Europe and North America. The dominant histology of liver cancer in almost all countries is hepatocellular carcinoma (HCC). The major risk factors for HCC—chronic infection with either hepatitis B virus (HBV) or hepatitis C virus (HCV), aflatoxin B1 (AFB1) contamination of foodstuffs, excessive alcohol consumption, and diabetes/obesity/fatty liver disease—all result in chronic inflammation in the liver. HBV infection is preventable by immunization, and HCV infection is largely preventable by public health measures and now is curable with new antiviral therapies.
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Keshav, Satish, and Palak Trivedi. Liver cancer. Edited by Patrick Davey and David Sprigings. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780199568741.003.0218.

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Primary hepatocellular carcinoma (HCC) arises from hepatocytes and is one of the commonest solid-organ malignancies in the world, particularly in the Far East and in sub-Saharan Africa. Cholangiocarcinoma arises from the biliary epithelium. The incidence is rising in the West, and primary sclerosing cholangitis (PSC) is an important risk factor (15% lifetime risk). Other forms of liver cancer include metastatic cancer, which is much more common in the West than any primary liver cancer, accounting for 90% of liver cancers and for which common primary sites are the colon, the stomach, the breasts, and the lungs; hepatoblastoma, which is an uncommon malignancy in children, originating from immature liver cell precursors; haemangiosarcomas, which are also rare, are malignant tumours arising from the blood vessels in the liver and can be very rapidly growing; and gall bladder cancer, arising from the gall bladder epithelium. Gallstones and PSC are risk factors for gall bladder cancer; in particular, PSC confers a risk >160 times that of the control population. This chapter primarily focuses on HCC.
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Iqbal, Muhammad Waqas, Michael E. Lipkin, and Glenn M. Preminger. Prevention of other non-calcium stones. Edited by John Reynard. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199659579.003.0016.

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Urolithiasis is a worldwide problem with an increase in incidence and prevalence affecting the quality of life of millions of people. While there have been significant advances in minimally invasive and endourological techniques to treat urinary stones, stone recurrence remains a substantial medical problem posing considerable social and financial burdens. Although debate continues on optimal metabolic workup in stone formers, identification of metabolic risk factors and medical preventive therapy is known to decrease stone recurrence. Specific treatment measures include targeted medical therapy tailored to individual stone types. In this chapter we discuss the current specific as well as non-specific measures to prevent non-calcium-based stones.
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Iqbal, Muhammad Waqas, Ghalib Jibara, Michael E. Lipkin, and Glenn M. Preminger. Evaluation of stone formers. Edited by John Reynard. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199659579.003.0014.

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Urolithiasis is among the most common urologic disorders with high incidence and recurrence rates. High environmental temperatures, prevalence of the Western diet, obesity, age, gender, and race are among the common risk factors associated with this disease. The primary goal of evaluating these patients is to provide a simple, economic, and effective workup, which yields information that is directly applicable to providing relevant medical preventative measures. The management of urolithiasis requires a relevant history, targeted physical exam, appropriate chemistry, urinary and stone analyses results, radiological imaging to accurately identify number, location, and size of stones, as well as a metabolic evaluation. All stone formers whether single or recurrent should have a basic evaluation to identify any factors that may predispose to recurrent stone formation. Comprehensive metabolic evaluations are offered to patients at increased risk of recurrence or morbidity from stone disease, or have difficult to treat stones.
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Taylor, Eric N., and Gary C. Curhan. Epidemiology of nephrolithiasis. Edited by Mark E. De Broe. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199592548.003.0199.

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Nephrolithiasis is common, costly, and painful. The prevalence of nephrolithiasis, defined as a history of stone disease, varies by age, sex, race, and geography while the incidence of nephrolithiasis, defined as the first stone event, varies by age, sex, and race. Epidemiologic studies have quantified the burden of kidney stone disease and expand our understanding of risk factors. A variety of dietary, non-dietary, and urinary risk factors contribute to the risk of stone formation and the importance of these varies by age, sex, and body mass index.Low fluid intake, high urinary oxalate or calcium or uric acid, and low urinary citrate are all associated with nephrolithiasis. These results from epidemiologic studies can be considered in the clinical setting when devising treatment plans to reduce stone recurrence.
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Turney, Ben, and John Reynard. Kidney stones. Edited by John Reynard. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199659579.003.0013.

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The composition of kidney stones is variable and the predisposing factors multifactorial. Consequently, a detailed evaluation of the patient’s lifestyle, diet, fluid intake, medical history, drug history, urinary tract anatomy, blood, and urine biochemistry and stone composition is required determine predisposing factors for stone formation in an individual patient. Combinatorial subtle variants in biochemistry may act synergistically to increase risk of stone formation/recurrence. Many medications may alter blood and/or urine biochemistry and predispose to stone formation. Corticosteroids increase absorption of calcium from the gut and cause hypercalciuria. Topirimate (for seizures or migraines), sulphasalazine (for rheumatoid arthritis), diuretics containing triamterene, acetazolamide (for myotonia), antacids containing trisilicate, calcium supplements, vitamin D supplements, vitamin C in high doses, indinavir (for HIV), and some herbal medicines (containing ephedrine) all increase stone risk.
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Turney, Ben, and John Reynard. Epidemiology of stone disease. Edited by John Reynard. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199659579.003.0012.

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In developed countries, the lifetime prevalence of kidney stones is around 10% and most commonly affects people in the working age-group. The incidence is increasing internationally. After passage of a first stone, the risk of recurrence is high. Direct and indirect costs involved in treating stones are considerable. Intrinsic risk factors include age, gender, genetics, and metabolic syndromes. The incidence of stone disease peaks between the ages of 20 and 60 years. While historically the male to female ratio was around 3:1, the gender gap is closing. The reasons for increased incidence are due in part to increased detection through better imaging but also due to environmental factors (e.g. diet, obesity, diabetes, dehydration) which put more people with an underlying genetic predisposition at risk. Despite the increasing prevalence of kidney stones, the majority are categorized as idiopathic.
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Book chapters on the topic "Risk factors for HCC recurrence"

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Ouchi, Kiyoaki, Shuji Matsubara, Kenji Fukuhara, and Seiki Matsuno. "Factors Affecting Long-Term Survival and Recurrence of Hepatocellular Carcinoma (HCC) After Hepatic Resection." In Recent Advances in Management of Digestive Cancers, 637–39. Tokyo: Springer Japan, 1993. http://dx.doi.org/10.1007/978-4-431-68252-3_188.

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Nault, Jean-Charles, and Jessica Zucman-Rossi. "Genomic Signatures of Risk Factors and Molecular Identification of HCC Subtypes." In Hepatocellular Carcinoma, 113–19. Cham: Springer International Publishing, 2016. http://dx.doi.org/10.1007/978-3-319-34214-6_6.

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Rouvier, Pierre, and Roger Peynegre. "Recurrence of Polyposis: Risk Factors, Prevention, Treatment and Follow-Up." In Micro-endoscopic Surgery of the Paranasal Sinuses and the Skull Base, 287–307. Berlin, Heidelberg: Springer Berlin Heidelberg, 2000. http://dx.doi.org/10.1007/978-3-642-57153-4_22.

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Van Nuffel, Maarten, and Ilse Degreef. "Is Recurrence After Treatment Predictable? Risk Factors in Dupuytren Disease." In Dupuytren Disease and Related Diseases - The Cutting Edge, 291–97. Cham: Springer International Publishing, 2016. http://dx.doi.org/10.1007/978-3-319-32199-8_39.

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Salazar, Javier, and Anne Le. "The Heterogeneity of Liver Cancer Metabolism." In The Heterogeneity of Cancer Metabolism, 127–36. Cham: Springer International Publishing, 2021. http://dx.doi.org/10.1007/978-3-030-65768-0_9.

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AbstractPrimary liver cancer is the fourth leading cause of cancer death around the world. Histologically, it can be divided into two major groups, hepatocellular carcinoma (75% of all liver cancer) and intrahepatic cholangiocarcinoma (15% of all liver cancer) [1, 2]. Primary liver cancer usually happens in liver disease or cirrhosis patients [1], and the risk factors for developing HCC depend on the etiology [3] and the country of provenance [1]. There is an urgent need for an accurate diagnostic test given the high proportion of false positives and false negatives for alpha-fetoprotein (AFP), a common HCC biomarker [4]. Due to often being diagnosed in advanced stages, HCCrelated deaths per year have doubled since 1999 [3]. With the use of metabolomics technologies [5], the aberrant metabolism characteristics of cancer tissues can be discovered and exploited for the new biomarkers and new therapies to treat HCC [6, 7].
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Ambrosone, Christine B., Chi-Chen Hong, and Pamela J. Goodwin. "Host Factors and Risk of Breast Cancer Recurrence: Genetic, Epigenetic and Biologic Factors and Breast Cancer Outcomes." In Improving Outcomes for Breast Cancer Survivors, 143–53. Cham: Springer International Publishing, 2015. http://dx.doi.org/10.1007/978-3-319-16366-6_10.

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Lim, Joon Seok, Honsoul Kim, and Nieun Seo. "Risk Factors for Recurrence and Tumor Response Evaluation After Neoadjuvant Therapy-Based Radiological Study." In Surgical Treatment of Colorectal Cancer, 63–73. Singapore: Springer Singapore, 2018. http://dx.doi.org/10.1007/978-981-10-5143-2_7.

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Sarig, S., R. Azoury, and S. Perlberg. "Use of Risk Factors in Medical Management to Reduce Recurrence of Calcium-Oxalate Kidney Stones." In Urolithiasis, 837. Boston, MA: Springer US, 1989. http://dx.doi.org/10.1007/978-1-4899-0873-5_265.

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Han, Kwang-Hyub, Jeong Il Jeong, Sang Hoon Ahn, Dong Kee Kim, Chae Yoon Chon, and Young Myoung Moon. "The Efficacy of the Ultrasonographic Screening Test for Early Detection of Hepatocellular Carcinoma and Risk Factors of HCC in Korea." In Progress in Hepatocellular Carcinoma Treatment, 1–9. Tokyo: Springer Japan, 2000. http://dx.doi.org/10.1007/978-4-431-67913-4_1.

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Balmes, J. L. "After interruption of the treatment, is the risk of recurrence elevated, and what other factors could be implicated in the determinism of reflux to avoid an indefinite intake of antacids?" In Benign Lesions of the Esophagus and Cancer, 330–33. Berlin, Heidelberg: Springer Berlin Heidelberg, 1989. http://dx.doi.org/10.1007/978-3-642-73055-9_91.

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Conference papers on the topic "Risk factors for HCC recurrence"

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Thu Huyen, Nguyen Thi, Mai Hong Bang, Tran Van Riep, and Nguyen Tien Thinh. "IDDF2018-ABS-0080 Risk factors for local recurrence in the treatment of radiofrequency ablation with cool-tip electrode for HCC patients." In International Digestive Disease Forum (IDDF) 2018, Hong Kong, 9–10 June 2018. BMJ Publishing Group Ltd and British Society of Gastroenterology, 2018. http://dx.doi.org/10.1136/gutjnl-2018-iddfabstracts.203.

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Shostak, E., R. Liberman, and D. Riker. "Stage I NSCLC: Risk Factors for Recurrence." In American Thoracic Society 2009 International Conference, May 15-20, 2009 • San Diego, California. American Thoracic Society, 2009. http://dx.doi.org/10.1164/ajrccm-conference.2009.179.1_meetingabstracts.a1107.

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Krambeck, Amy E., Laureano J. Rangel, Andrew J. LeRoy, David E. Patterson, Matthew T. Gettman, James C. Williams, Andrew P. Evan, James E. Lingeman, and James A. McAteer. "Risk Factors for Stone Recurrence after Percutaneous Nephrolithotomy." In RENAL STONE DISEASE 2: 2nd International Urolithiasis Research Symposium. AIP, 2008. http://dx.doi.org/10.1063/1.2998038.

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Hamao, Nobuyoshi, Isao Ito, Naoya Tanabe, Satoshi Konishi, Masahiro Shirata, Issei Oi, Seiichiro Imai, Hisako Matsumoto, and Toyohiro Hirai. "Risk factors for recurrence of fever in aspiration pneumonia." In ERS International Congress 2020 abstracts. European Respiratory Society, 2020. http://dx.doi.org/10.1183/13993003.congress-2020.2024.

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Ueno, A., M. Hirata, Y. Yamamura, K. Fujita, N. Shibutou, and M. Yamamura. "AB0646 Identification of risk factors for recurrence in polymyalgia rheumatica." In Annual European Congress of Rheumatology, EULAR 2018, Amsterdam, 13–16 June 2018. BMJ Publishing Group Ltd and European League Against Rheumatism, 2018. http://dx.doi.org/10.1136/annrheumdis-2018-eular.7128.

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Mizumori, Yasuyuki, Nobuya Hirata, Ryota Hiraoka, Katsuya Hirano, Ryota Kominami, Sayaka Takahashi, Yasushi Fukuda, et al. "Preoperative biopsy risk for recurrence?: A retrospective study of risk factors for recurrence of stage 1A non-small cell lung cancer." In ERS International Congress 2017 abstracts. European Respiratory Society, 2017. http://dx.doi.org/10.1183/1393003.congress-2017.pa3775.

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Kim, HJ, and JS Kim. "RISK FACTORS FOR RECURRENCE OF STONE AFTER COMMON BILE DUCT STONES REMOVAL." In ESGE Days. © Georg Thieme Verlag KG, 2020. http://dx.doi.org/10.1055/s-0040-1704965.

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Erol, Serhat, Aslihan Gurun, Fatma Ciftci, Aydin Ciledag, Akin Kaya, Elif Sen, Gokhan Celik, and Ismail Savas. "Clinical characteristics of elderly patients with pulmonary embolism and risk factors for recurrence." In ERS International Congress 2016 abstracts. European Respiratory Society, 2016. http://dx.doi.org/10.1183/13993003.congress-2016.pa2493.

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Hwang, In Sun, Chaewon Kim, Keun Ho Lee, and Jigeun Yoo. "2022-RA-197-ESGO Risk factors and patterns of recurrence in patients with low-risk endometrial cancer." In ESGO 2022 Congress. BMJ Publishing Group Ltd, 2022. http://dx.doi.org/10.1136/ijgc-2022-esgo.205.

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Spagnol, G., I. Pezzani, G. Corrao, S. Gava, V. Bernardini, S. Kilzie, G. Artioli, et al. "230 The role of prognostic risk factors in endometrial cancer recurrence: a retrospective study." In ESGO 2021 Congress. BMJ Publishing Group Ltd, 2021. http://dx.doi.org/10.1136/ijgc-2021-esgo.127.

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Reports on the topic "Risk factors for HCC recurrence"

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Qian, Ao, Xin Zhang, Gang Huo, Jiaojiao Yu, and Xiaoshu Wang. Risk factors of recurrence in Rathke cleft cyst: a systematic review and meta analysis. INPLASY - International Platform of Registered Systematic Review and Meta-analysis Protocols, October 2021. http://dx.doi.org/10.37766/inplasy2021.10.0070.

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Guo, Zhiyi, Kejia Yang, Jing Lei, Yongjian Zeng, Zhidong Guo, and Fenghua Zhang. Risk factors for recurrence of tic disorders in children:a systematic review and Meta-analysis. INPLASY - International Platform of Registered Systematic Review and Meta-analysis Protocols, February 2022. http://dx.doi.org/10.37766/inplasy2022.2.0078.

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Hubsky, Ashlee. Hepatocellular Carcinoma Recurrence After Liver Transplantation: An Analysis of Risk Factors and Incidence from Oregon Health Science University. Portland State University Library, January 2016. http://dx.doi.org/10.15760/honors.213.

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Shumway, Dean A., Kimberly S. Corbin, Magdoleen H. Farah, Kelly E. Viola, Tarek Nayfeh, Samer Saadi, Vishal Shah, et al. Partial Breast Irradiation for Breast Cancer. Agency for Healthcare Research and Quality (AHRQ), January 2023. http://dx.doi.org/10.23970/ahrqepccer259.

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Objectives. To evaluate the comparative effectiveness and harms of partial breast irradiation (PBI) compared with whole breast irradiation (WBI) for early-stage breast cancer, and how differences in effectiveness and harms may be influenced by patient, tumor, and treatment factors, including treatment modality, target volume, dose, and fractionation. We also evaluated the relative financial toxicity of PBI versus WBI. Data sources. MEDLINE®, Embase®, Cochrane Central Registrar of Controlled Trials, Cochrane Database of Systematic Reviews, Scopus, and various grey literature sources from database inception to June 30, 2022. Review methods. We included randomized clinical trials (RCTs) and observational studies that enrolled adult women with early-stage breast cancer who received one of six PBI modalities: multi-catheter interstitial brachytherapy, single-entry catheter brachytherapy (also known as intracavitary brachytherapy), 3-dimensional conformal external beam radiation therapy (3DCRT), intensity-modulated radiation therapy (IMRT), proton radiation therapy, intraoperative radiotherapy (IORT). Pairs of independent reviewers screened and appraised studies. Results. Twenty-three original studies with 17,510 patients evaluated the comparative effectiveness of PBI, including 14 RCTs, 6 comparative observational studies, and 3 single-arm observational studies. PBI was not significantly different from WBI in terms of ipsilateral breast recurrence (IBR), overall survival, or cancer-free survival at 5 and 10 years (high strength of evidence [SOE]). Evidence for cosmetic outcomes was insufficient. Results were generally consistent when PBI modalities were compared with WBI, whether compared individually or combined. These PBI approaches included 3DCRT, IMRT, and multi-catheter interstitial brachytherapy. Compared with WBI, 3DCRT showed no difference in IBR, overall survival, or cancer-free survival at 5 and 10 years (moderate to high SOE); IMRT showed no difference in IBR or overall survival at 5 and 10 years (low SOE); multi-catheter interstitial brachytherapy showed no difference in IBR, overall survival, or cancer-free survival at 5 years (low SOE). Compared with WBI, IORT was associated with a higher IBR rate at 5, 10, and over 10 years (high SOE), with no difference in overall survival, cancer-free survival, or mastectomy-free survival (low to high SOE). There were significantly fewer acute adverse events (AEs) with PBI compared with WBI, with no apparent difference in late AEs (moderate SOE). Data about quality of life were limited. Head-to-head comparisons between the different PBI modalities showed insufficient evidence to estimate an effect on main outcomes. There were no significant differences in IBR or other outcomes according to patient, tumor, and treatment characteristics; however, data for subgroups were insufficient to draw conclusions. Eight studies addressed concepts closely related to financial toxicity. Compared with conventionally fractionated WBI, accelerated PBI was associated with lower transportation costs and days away from work. PBI was also associated with less subjective financial difficulty at various time points after radiotherapy. Conclusions. Clinical trials that compared PBI with WBI demonstrate no significant difference in the risk of IBR. PBI is associated with fewer acute AEs and may be associated with less financial toxicity. The current evidence supports the use of PBI in appropriately selected patients with early-stage breast cancer. Further investigation is needed to evaluate the outcomes of PBI in patients with various clinical and tumor characteristics, and to define optimal radiation treatment dose and technique for PBI.
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