Prognosis of unresectable hepatocellular carcinoma: An evaluation based on multivariate analysis of 90 cases

Abstract

A multivariate analysis of data from 90 patients with unresectable hepatocellular carcinoma was performed using Cox's regression model to identify factors possibly affecting their prognoses. Thirty-one patients underwent arterial anticancer chemotherapy, and the remaining 59 patients received transcatheter arterial embolization with anticancer agents. Four of 27 variables tested for all the patients (i.e., encapsulation [p less than 0.05], gross appearance of hepatocellular carcinoma [p less than 0.01], clinical stage [p less than 0.01] and therapy [p less than 0.01]) were found to be prognostically significant. Five of 27 variables tested were prognostically significant for the transcatheter arterial embolization group; they were an extension rate of hepatocellular carcinoma (p less than 0.01), encapsulation (p less than 0.01), alpha-fetoprotein (p less than 0.01), prothrombin time (p less than 0.01) and serum sodium (p less than 0.01). Regression equations were used to describe a prognostic index. A prognostic index was defined as the regression equation derived from the results of a total of 90 patients; PI-1 = eY, where PI-1 = prognostic index 1 Y = 1.549 (gross appearance of hepatocellular carcinoma - 1.344) + 0.778 (encapsulation - 1.622) + 0.818 (clinical stage - 1.800) + 1.760 (therapy - 1.344) and prognostic index 2, the regression equation derived from the results of the transcatheter arterial embolization group of patients; PI-2 = eY, where PI-2 = prognostic index 2 Y = 1.210 (extension rate of hepatocellular carcinoma - 1.576) + 1.179 (encapsulation - 1.475) + 0.0001277 (alpha-fetoprotein - 1420.792) -0.039 (prothrombin time - 72.237) - 0.214 (serum sodium - 138.427).(ABSTRACT TRUNCATED AT 250 WORDS)

Survival benefit of patients with inoperable hepatocellular carcinoma treated by a combination of transarterial chemoembolization and percutaneous ethanol injection—a single-center analysis including 132 patients

“…Because the 3-year survival rate of patients with compensated liver cirrhosis and small untreated HCCs is only 25% (Barbara et al, 1992), the follow-up period in our study (mean 15 months, IQR 9-26) with mostly advanced HCCs was adequate. Similar to previous studies (Livraghi et al, 1995;Akashi et al, 1991), we found a good correlation between the estimated survival time and liver function or tumor stage, while histological differentiation was of marginal prognostic relevance. Furthermore, we found that patients with baseline AFP levels Ͻ100 ng/ml and no portal vein thrombosis had a significantly longer survival (Table II).…”

Clinical significance of circulating anti-p53 antibodies in European patients with hepatocellular carcinoma

“…As previously mentioned, eight patients of our series operated for HCC had antip53 serum antibodies, and at least one factor of bad prognosis as defined by the experience of different groups (Akashi et al, 1991;Yamashita et al, 1991;Bismuth et al, 1993;Ganne-CariŽ et al, 1996). However, they all had a survival rate without recurrence significantly higher than that of the 24 patients with vascular invasion but without circulating anti-p53 antibodies (P = 0.05, logrank analysis).…”

Hypothermic Cardiac Arrest to Remove Right Atrial Thrombi Due to Abdominal Malignancies

“…The natural history of HCC complicated with macroscopic vascular invasion of the portal vein, shows a median survival time of only 9 to 10 weeks (Okada et al, 1992). Treatments with systemic chemotherapy, intra-arterial chemotherapy or radiofrequency ablation result in a dismal survival at 1 year ranging from 7% to 18% (Raul et al, 1994;Akashi et al, 1991;Poon et al, 2003). Hepatic resection remains the only option for these patients and a recent multicentric study showed that, resected patients lived longer, compared to those not treated surgically, with a five-year survival rate of 10% (Pawlik et al, 2005;Lin et al, 2007).…”