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Hepatocellular carcinoma in the United States: Prognostic features, treatment outcome, and survival
Author(s) -
Stuart Keith E.,
Anand Ajay J.,
Jenkins Roger L.
Publication year - 1996
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/(sici)1097-0142(19960601)77:11<2217::aid-cncr6>3.0.co;2-m
Subject(s) - medicine , hepatocellular carcinoma , cirrhosis , gastroenterology , medical record , retrospective cohort study , population , liver cancer , cancer , stage (stratigraphy) , carcinoma , surgery , paleontology , environmental health , biology
BACKGROUND The purpose of this study was to investigate prognostic factors at presentation and the survival of North American patients with hepatocellular carcinoma (HCC). METHODS A retrospective analysis of medical records was performed for 314 patients identified through the Tumor Registry as having been evaluated for hepatocellular carcinoma at the Deaconess Hospital, Boston, Massachusetts, from 1986 through 1995. Clinical characteristics were noted, including age, sex, TNM staging, serum biochemistries, serum alpha‐fetoprotein (AFP), patency of portal vasculature, cirrhosis, history of alcohol abuse, hepatitis‐B or C positivity, hemochromatosis, treatment received, and ultimate survival from the date of diagnosis. RESULTS Overall median survival was 10 months. The presence of cirrhosis, a history of alcohol abuse, low albumin, high bilirubin, abnormal AFP, and portal vein obstruction (PVO) were each associated with significantly shorter survival, as was advanced stage. Only albumin, AFP, and PVO were independent risk factors by multiple regression analysis. Patients undergoing surgery had the longest median survival (45 months), followed by those receiving chemoembolization (14 months). Those patients who were untreated or received systemic chemotherapy alone had significantly shorter survivals (2‐4 months). CONCLUSIONS Despite the difference in the underlying etiology of HCC in this population compared with Asian patients, poor prognostic indicators are similar. In this large series of patients at a single Northeastern hospital, analysis of presenting clinical characteristics was found to offer useful prognostic information. Cancer 1996;77:2217‐22.