Predictors of Short- and Long-term Mortality in Hepatocellular Carcinoma - Development of a Predictive Model

Abstract

Introduction: The prognosis of patients with hepatocellular carcinoma (HCC) is not solely related to tumour stage, being determined by a complex set of factors [1]. The aims of this study were to characterize the prognostic factors in patients with HCC and to create a predictive model for survival in this population. Methods: We performed a retrospective analysis involving patients diagnosed with HCC between 2010 and 2015 in a tertiary referral center. Survival rates at 6, 12 and 24 months were determined and a predictive model of survival was calculated after logistic regression analysis of significant prognostic factors. Results: We included 172 HCC patients, mainly male (87%), with median age of 64 years (IQR: 19), followed for a median period of 16 months (IQR: 4-30). Eighty-six percent had cirrhosis, and alcohol was the major cause of liver disease (27%). At diagnosis most were Child-Pugh A (51%) and classified as BCLC stage A (26%). Half of the cases were diagnosed in the screening program. At diagnosis, 53% had a single nodule, 19% had multifocal HCC and 13% had extrahepatic disease. The survival rates at 6, 12 and 24 months were 78%, 68% and 45%, respectively. In the regression model, diagnosis of HCC in the context of screening, extrahepatic metastasis, hypoalbuminemia. Conclusion: We created an accurate predictive model of 6- and 24-month survival in patients with HCC, that is easy to calculate, including only three simple clinical variables: serum albumin, extrahepatic metastasis and size of liver nodules at diagnosis.