Current state and clinical outcome in Turkish patients with hepatocellular carcinoma

• 作者: Arzu Poyanli Asli Cifcibasi Ormeci Bulent Baran Cetin Karaca Fatih Besisik Filiz Akyuz Kadir Demir Mine Gulluoglu Omer Ekinci Ozlem Mutluay Soyer Sabahattin Kaymakoglu Sami Evirgen Suut Gokturk
• 来源期刊: 世界肝病学杂志：英文版（电子版）
• 学科: 医学
• 关键词: HEPATOCELLULAR carcinoma CIRRHOSIS Alfafetoprotein PROGNOSIS Treatment SURVIVAL
• 年，卷（期）: 2018,（1）
• 页码范围: 51-61
• 页数: 11页
• 分类号: R

摘要

AIM To investigate clinical,etiological,and prognostic features in patients with hepatocellular carcinoma.METHODS Patients with hepatocellular carcinoma who were followed-up from 2001 to 2011 were included in the study.The diagnosis was established by histopathological and/or radiological criteria.We retrospectively reviewed clinical and laboratory data,etiology of primary liver disease,imaging characteristics and treatments.Child-Pugh and Barcelona Clinic Liver Cancer stage was determined at initial diagnosis.Kaplan-Meier survival analysis was done to find out treatment effect on survival.Risk factors for vascular invasion and overall survival were investigated by multivariate Cox regression analyses.RESULTS Five hundred and forty-five patients with hepatocellular carcinoma were included in the study.Viral hepatitis was prevalent and 68 patients either had normal liver or were non-cirrhotic.Overall median survival was 16(13-19)mo.Presence of extrahepatic metastasis was associated with larger tumor size(OR=3.19,95%CI:1.14-10.6).Independent predictor variables of vascular invasion were AFP(OR=2.95,95%CI:1.38-6.31),total tumor diameter(OR=3.14,95%CI:1.01-9.77),and hepatitis B infection(OR=5.37,95%CI:1.23-23.39).Liver functional reserve,tumor size/extension,AFP level and primary treatment modality were independent predictors of overall survival.Transarterial chemoembolization(HR=0.38,95%CI:0.28-0.51)and radioembolization(HR=0.36,95%CI:0.18-0.74)provided a comparable survival benefit in the real life setting.Surgical treatments as resection and transplantation were found to be associated with the best survival compared with loco-regional treatments(log-rank,P<0.001).CONCLUSION Baseline liver function,oncologic features including AFP level and primary treatment modality determines overall survival in patients with hepatocellular carcinoma.