table_1_Liver Cancer Disparities in New York City: A Neighborhood View of Risk and Harm Reduction Factors.docx

Introduction<p>Liver 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.</p>Materials and methods<p>Publicly 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.</p>Results<p>Liver 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.</p>Conclusion<p>High 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.</p

Trials for Oligometastatic Disease.

<p>Abbreviations: LC, local control; DC, distant control; PFS, progression-free survival; OS, overall survival; fx, fractions; NR = not reported.</p

Adverse Events.

*<p>One case occurred after sunitinib treatment and was likely related to reirradiation performed prior to protocol therapy.</p

Kaplan-Meier survival curves.

<p>a) Overall survival. b) Local control. c) Distant control. d) Progression-free survival.</p

Representative patient treated with concurrent sunitinib and IGRT.

<p>a) Pretreatment PET/CT demonstrates a biopsy proven solitary metastasis in the right 7^th rib in a patient with non-small cell lung cancer. b) The rib lesion was treated with Novalis using dynamic arcs using the ITV method with an abdominal belt used to dampen respiratory motion. Daily kV imaging was accomplished using bone fusion. There was excellent coverage of the PTV with selective sparing of the normal lung, liver and skin. c) Complete response on PET/CT 23 months after Sutent +RT.</p

CONSORT flowchart.

<p>CONSORT flowchart.</p