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Prognostic factors of hepatocellular carcinoma in the west: A multivariate analysis in 206 patients
Author(s) -
Calvet Xavier,
Bruix Jordi,
Ginés Pere,
Bru Concepció,
Sole Manel,
Vilana Ramón,
Rodés Joan
Publication year - 1990
Publication title -
hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.488
H-Index - 361
eISSN - 1527-3350
pISSN - 0270-9139
DOI - 10.1002/hep.1840120422
Subject(s) - hepatocellular carcinoma , ascites , medicine , gastroenterology , bilirubin , proportional hazards model , anorexia , carcinoma , blood urea nitrogen , multivariate analysis , oncology , creatinine
To investigate the prognostic factors in Western patients with hepatocellular carcinoma, 206 patients with confirmed diagnoses of hepatocellular carcinoma were studied in terms of survival. All patients were diagnosed between 1983 and 1987. A multivariate survival analysis (Cox regression model) using clinical, biochemical, ultrasonographical and pathological data obtained at diagnosis disclosed that bilirubin (p = 0.0001), ascites (p = 0.0001), toxic syndrome (defined by the presence of weight loss > 10% premorbid weight, malaise and anorexia) (p = 0.009), blood urea nitrogen (p = 0.025), tumor size (p = 0.001), γ‐glutamyltranspeptidase (p = 0.0006), age (p = 0.0005), serum sodium (p = 0.003) and presence of metastases (p = 0.002) were independent predictors of survival. According to the contribution of each of these factors to the final model, a prognostic index was constructed allowing division of patients in different groups according to their relative risk of death: RRD = EXP (Age × 0.03 + Ascites × 0.8281 + BUN × 0.0137 + Serum sodium × (− 0.0538) + γ‐Glutamyltranspeptidase × 0.0019 + Bilirubin × 0.0734 + Tumor size × 0.33 + Toxic syndrome × 0.4965 + Metastases × 0.55). These results facilitate the stratification of hepatocellular carcinoma patients to design and evaluate future controlled trials. (HEPATOLOGY 1990;12:753–760).