Prognosis of unresectable hepatocellular carcinoma: An evaluation based on multivariate analysis of 90 cases

Abstract

A multivariate analysis of data from 90 patients with unresectable hepatocellular carcinoma was performed using Cox's regression model to identify factors possibly affecting their prognoses. Thirty-one patients underwent arterial anticancer chemotherapy, and the remaining 59 patients received transcatheter arterial embolization with anticancer agents. Four of 27 variables tested for all the patients (i.e., encapsulation [p less than 0.05], gross appearance of hepatocellular carcinoma [p less than 0.01], clinical stage [p less than 0.01] and therapy [p less than 0.01]) were found to be prognostically significant. Five of 27 variables tested were prognostically significant for the transcatheter arterial embolization group; they were an extension rate of hepatocellular carcinoma (p less than 0.01), encapsulation (p less than 0.01), alpha-fetoprotein (p less than 0.01), prothrombin time (p less than 0.01) and serum sodium (p less than 0.01). Regression equations were used to describe a prognostic index. A prognostic index was defined as the regression equation derived from the results of a total of 90 patients; PI-1 = eY, where PI-1 = prognostic index 1 Y = 1.549 (gross appearance of hepatocellular carcinoma - 1.344) + 0.778 (encapsulation - 1.622) + 0.818 (clinical stage - 1.800) + 1.760 (therapy - 1.344) and prognostic index 2, the regression equation derived from the results of the transcatheter arterial embolization group of patients; PI-2 = eY, where PI-2 = prognostic index 2 Y = 1.210 (extension rate of hepatocellular carcinoma - 1.576) + 1.179 (encapsulation - 1.475) + 0.0001277 (alpha-fetoprotein - 1420.792) -0.039 (prothrombin time - 72.237) - 0.214 (serum sodium - 138.427).(ABSTRACT TRUNCATED AT 250 WORDS)

Gender-based outcomes differences in unresectable hepatocellular carcinoma

“…The present analysis is based on a large study with extensive data on clinical covariates collected at the time of diagnosis in patients with unresectable HCC over a period of 17 years. A sample size of 279 female patients (despite the fact that they represented only one third of the study population), with adequate and long-term follow-up data has allowed us a more detailed analysis of HCC progression in the two sexes than has previously been reported [7][8][9][10]. Results of our univariate analysis showed differences in distribution of tumor burden and residual liver function between sexes at the time of presentation.…”

“…Despite evidence suggesting that testosterone is a growth stimulus to Transforming Growth Factor alpha (TGFa) mitogenic actions, which could stimulate hepatocarcinogenesis and hepatocyte proliferation [6]; it remains unknown whether the natural history of HCC is different between the 2 sexes. Controversial reports also exist on the contribution of sex differences to patient survival and prognosis [7][8][9][10]. However, few studies have compared the clinicopathologic characteristics of patients and their impact on survival with specific reference to gender in a large sample set.…”

Prognostic Index for Survival in Patients After Treatment for Primary Hepatocellular Carcinoma

“…Therefore, it is thought appropriate that the PI was classified into three groups: high risk, intermediate risk, and low risk. The PI has been reported to be useful for predicting the prognosis of patients after TACE [14,[26][27][28]. However, our study differed in terms of the subjects, the items investigated, the type of therapy from the Okuda score, and the CLIP score [27,28].…”

Effectiveness of endoscopic biliary drainage for unresectable hepatocellular carcinoma associated with obstructive jaundice

“…Consequently, it is not a commonly used procedure in patients with advanced inoperable HCC and obstructive jaundice, and the indications for EBD in these patients are also controversial because of their short survival. Many studies [10][11][12][13][14] have defined prognostic factors for the survival of HCC patients. Tumor thrombus in the portal vein is one of the reliable indicators of a poor prognosis 12 and is usually considered a contraindication to transarterial chemoembolization (TAE).…”