Predictors of Survival in Hepatocellular Carcinoma Patients

Abstract

Background: Hepatocellular carcinoma (HCC) is the fifth most common tumor worldwide, with an incidence equal to the death rate.

Material/Methods: We aimed to detect the prognostic factors for HCC patients. We retrospectively analyzed 12 years data of 115 patients who have biopsy-proven HCC. Clinical and demographic characteristics of patients with treatment modalities, survival rates, and prognostic factors were analyzed.

Results: There were 93 male patients, and the mean age was 63.5 +/- 11.8 years. Most patients had cirrhosis due to hepatitis virus infection. Median follow-up time was 17 months (1 month-9.5 years) after the diagnosis of HCC. The nodule was single in 43 (37.4%) patients, there were 2-3 nodules in 30 (26.1%), and >3 or diffuse nodules in 42 (36.5%) patients. Distribution of treatment modalities was as follows: 23 (20%) patients had liver transplantation, 15 (13%) had HCC resection, 12 patients (10.4%) had radiofrequency ablation (RFA), 26 patients (22.6%) had transarterial chemoembolization (TACE), 2 (1.7%) had alcohol ablation, and 37 patients (32.2%) had no treatment. Tumor sizes of 9 patients (39.1%) in the transplanted group exceeded the Milan criteria. Mean survival was 72 +/- 6.9, 78.8 +/- 12.5, 19.5 +/- 2.8, 20.6 +/- 4.2, 16.0 +/- 5.9 months in those that received transplantation, resection, RFA, TACE, and no treatment, respectively (p<0.001). Survival was significantly poorer in patients >63 years old (p=0.001), with serum albumin level <= 3.4 g/dL (p=0.01), and with diffuse HCC (p<0.001).

Conclusions: Survival was significantly better in patients who underwent liver transplantation or surgical resection. Tumor number, age, and serum albumin level were the most important prognostic factors related to overall survival.