Abstract
BackgroundAlthough men carry a higher risk of hepatocellular carcinoma (HCC) than women, it is still controversial whether men also have a poorer postoperative prognosis. A retrospective study was conducted to evaluate the postoperative prognostic predictors of HCC focusing on sex differences.MethodsWe enrolled 516 consecutive adult patients with HCC (118 women, 398 men), who received surgical resection between January 2000 and December 2007, and were followed-up for >10 years. Clinical and laboratory data together with postoperative outcomes were reviewed.ResultsAt baseline, female patients had a higher anti-hepatitis C virus antibody prevalence (P = 0.002); lower hepatitis B virus surface antigen prevalence (P = 0.006); less microvascular invasion (P = 0.019); and lower alpha-fetoprotein (P = 0.023), bilirubin (P = 0.002), and alanine transaminase (P = 0.001) levels. Overall, there were no significant sex differences in terms of intrahepatic recurrence-free survival (RFS), distant metastasis-free survival (MFS), and overall survival (OS). However, subgroup analysis showed that women had favorable RFS (P = 0.019) and MFS (P = 0.034) in patients with alpha-fetoprotein ≤ 35 ng/mL, independent of other clinical variables (adjusted P = 0.008 and 0.043, respectively). Additionally, men had favorable OS in patients with prothrombin time (international normalized ratio [INR]) <1.1 (P = 0.033), independent of other clinical variables (adjusted P = 0.042).ConclusionsFemale sex is independently associated with favorable postoperative RFS and MFS in patients with alpha-fetoprotein ≤35 ng/mL, while male sex is independently associated with favorable OS in patients with prothrombin time INR <1.1.
Highlights
Men carry a higher risk of hepatocellular carcinoma (HCC) than women, it is still controversial whether men have a poorer postoperative prognosis
745,000 people die of liver cancer each year, making it the second leading cause of cancer-related death
Baseline characteristics between male and female patients with HCC A total of 516 patients who received surgical resection for HCC were included in this study
Summary
Men carry a higher risk of hepatocellular carcinoma (HCC) than women, it is still controversial whether men have a poorer postoperative prognosis. Liver cancer is ranked as the sixth most common solid cancer worldwide, with an estimated occurrence of 782,000 new cases each year. It is ranked fifth among cancers in men (554,000 cases/year) and ninth among cancers in women (228,000 cases/year). 745,000 people die of liver cancer each year, making it the second leading cause of cancer-related death. It is ranked the second deadliest cancers in men (521,000 deaths/year) and the fourth most deadly cancers in women (224,000 deaths/year) [1]. In the Asia-Pacific region, men are affected 1.3- (Japan) to 4.7-fold (Singapore) more frequently than women [8]
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