Estrogen Replacement Reduces Risk and Increases Survival Times of Women With Hepatocellular Carcinoma Manal M. Hassan, Gehan Botrus, Reham Abdel-Wahab,

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Estrogen Replacement Reduces Risk and Increases Survival Times of Women With Hepatocellular Carcinoma Manal M. Hassan, Gehan Botrus, Reham Abdel-Wahab,

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Estrogen Replacement Reduces Risk and Increases Survival Times of Women With Hepatocellular Carcinoma Manal M. Hassan, Gehan Botrus, Reham Abdel-Wahab, Robert A. Wolff, Donghui Li, David Tweardy, Alexandria T. Phan, Ernest Hawk, Milind Javle, Ju-Seog Lee, Harrys A. Torres, Asif Rashid, Renato Lenzi, Hesham M. Hassabo, Yasmin Abaza, Ahmed S. Shalaby, Sahin Lacin, Jeffrey Morris, Yehuda Z. Patt, Christopher I. Amos, Saira A. Khaderi, John A. Goss, Prasun K. Jalal, Ahmed O. Kaseb Clinical Gastroenterology and Hepatology Volume 15, Issue 11, Pages 1791-1799 (November 2017) DOI: 10.1016/j.cgh.2017.05.036 Copyright © 2017 AGA Institute Terms and Conditions

Figure 1 Predicted mean age at hepatocellular carcinoma onset and duration of estrogen use by linear regression; for example, the predicted mean ages (95% CI) at hepatocellular carcinoma onset at 6, 16, and 31 years of estrogen exposure were 63.9 (61.9-65.9), 64.8 (62.7-66.9), and 66.2 (61.6-70.8), respectively. Clinical Gastroenterology and Hepatology 2017 15, 1791-1799DOI: (10.1016/j.cgh.2017.05.036) Copyright © 2017 AGA Institute Terms and Conditions

Figure 2 (A) Median overall survival and 95% confidence interval (CI) by estrogen use. (B) Univariate hazard ratios and 95% CI of hepatocellular carcinoma prognostic factors. (C) Multivariate-adjusted hazard ratio (AHR) of estrogen use (0.55; 95% CI, 0.40–0.77) after adjusting for significant confounding factors of survival including race, hysterectomy, oophorectomy, multinodular tumor, cirrhosis, extrahepatic metastasis, >50% liver involvement, alpha-fetoprotein (AFP), vascular invasion, TNM staging, and treatment type. HBV, hepatitis B virus; HCV, hepatitis C virus. Clinical Gastroenterology and Hepatology 2017 15, 1791-1799DOI: (10.1016/j.cgh.2017.05.036) Copyright © 2017 AGA Institute Terms and Conditions