Prognostic factors on survival in hepatocellular carcinoma

Abstract

Purpose: Hepatocellular carcinoma is a potentially recurrent tumor determining the predictive factors effective on recurrence and mortality. Methods: In Seoul National University Bundang Hospital, 478 patients were operated for hepatocellular carcinoma between 2004 and 2015.Among them, data of 216 patients was obtained from prospectively collected data repository for determining the oncological outcomes. The exclusion criteria were the patients with R1 resection, history of preoperative tumor rupture and causes of mortality unrelated with hepatocellular carcinoma. Results: Among 216 patients, 124 patients had recurrences and 54 patients died during follow-up period. The BMI (<24kg/m2), number of postoperative TACE, were also significant in OS; but the male gender and presence of portal vein invasion were only significant in DFS. Finally in multiple Cox regression analyses; independent factors were BMI (p:0.001, HR: 0.85, 95% CI: 0.77-0.93), presence of satellite lesions (p: 0.000, HR: 4.56, 95% CI: 2.43-8.56) and number of lesions (<2) (p:0.001, HR:2.9, 95% CI: 1.56-5.51) in OS and male gender (p:0.013, HR: 2.05, 95% CI: 1.16-3.63), presence of satellite lesions (p: 0.001, HR: 2.35, 95% CI: 1.39-3.96) and grosstype of tumor (p:0.008, HR:5.95, 95% CI: 1.58- 22.3) in DFS.1.-3.-5.y. survival rates were 93%-85.7%-79.2%; with the recurrence free rates of 78.1% - 54.9% - 41.6% respectively. Conclusion: In this study, tumor size, number of tumors and male gender was also a strong indicator for recurrence. Interestingly, low BMI was a strong indicator for worrisome survival outcomes.