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Paraneoplastic syndromes in patients with hepatocellular carcinoma in Taiwan
Author(s) -
Luo JiingChyuan,
Hwang ShinnJang,
Wu JawChing,
Li ChungPin,
Hsiao LinagTsai,
Lai ChiungRu,
Chiang JenHuei,
Lui WingYiu,
Chang FullYoung,
Lee ShouDong
Publication year - 1999
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(19990901)86:5<799::aid-cncr15>3.0.co;2-#
Subject(s) - medicine , hepatocellular carcinoma , oncology , pathology , dermatology
BACKGROUND Hepatocellular carcinoma (HCC) is the most common malignancy in Taiwan. Some patients may manifest paraneoplastic syndromes during the clinical course of the disease. In this study, the authors evaluated the clinical significance of these paraneoplastic syndromes, compared the prevalence of these syndromes between cases of hepatitis B virus (HBV)–related and hepatitis C virus (HCV)–related HCC, and estimated significant predictors associated with the syndromes. METHODS Clinical data on 1197 HCC patients, including age, gender, Child–Pugh score, survival time, laboratory data (including liver biochemistry, hepatitis markers, and serum α‐fetoprotein [AFP]), and tumor features (including tumor size, portal vein thrombosis, and histologic pictures), were retrospectively reviewed. RESULTS A total of 232 of 1197 patients (19.4%) had paraneoplastic syndromes. HCC patients with paraneoplastic syndromes had significantly higher serum AFP; higher rates of initial main portal vein thrombosis, metastasis, and bilobal tumor involvement; larger tumor volume; and shorter survival than those without these syndromes. Patients with HBV‐related HCC had a significantly higher prevalence of paraneoplastic syndromes than patients with HCV‐related HCC (20.1% vs. 11.2%, P = 0.005). In a stepwise multivariate logistic regression analysis, AFP >50,000 ng/mL and tumor volume >30% were significant predictive variables associated with the presence of paraneoplastic syndromes in HCC patients. CONCLUSIONS HCC patients with paraneoplastic syndromes usually had higher levels of serum AFP and larger tumor volumes than those without. Patients with HBV‐related HCC had a significantly higher prevalence of paraneoplastic syndromes than those with HCV‐related HCC. Cancer 1999;86:799–804. © 1999 American Cancer Society.