Tumor growth rates and recurrence-free survival in chronic viral hepatitis patients with hepatocellular carcinoma

Abstract

Aim: Survival in patients with hepatocellular carcinoma (HCC) is impacted by stage of liver disease, tumor characteristics, and HCC surveillance in high-risk individuals. Factors associated with HCC tumor growth rate (TGR) and its influence on recurrence-free survival after treatment was investigated. Methods: TGR was calculated in 164 HCC patients with chronic viral hepatitis who had two consecutive magnetic resonance imaging or computed tomography scans ≥ 30 days apart prior to treatment and who were followed prospectively to determine the rates of recurrence-free survival. Results: The median TGR in 164 patients was 17.8% per month (mean 33.3% per month). Regression tree analysis indicated that the top three predictors of TGR were alpha-fetoprotein (AFP) levels (≥ 16.7 ng/mL), platelet counts (≥ 140,000 mm 3), and serum albumin level (< 3.55 g/dL). The regression tree identified patient groups with TGRs ranging from 0.65% to 39.4% per month. At a median follow-up of 22 months, the overall recurrence-free survival was 53.8%.

Nonalcoholic fatty liver disease-related hepatocellular carcinoma growth rates and their clinical outcomes

“…Our comparative studies revealed that HBV sub-cohort patients had more rapid HCC TGRs than HCV and NAFLD sub-cohort patients in line with prior studies reporting a variance in HCC TGRs based on chronic liver disease etiology [13,23,24] . Rich et al [13] studied HCC TGR patterns in a heterogeneous group of patients in western countries and reported that non-viral HCC etiologies had more indolent growth than viral causes. However, 70% of their study cohort comprised HCV patients (n = 169) while only 6.6% and 11.1% were comprised of NAFLD (n = 16) and HBV (n = 8) patients, respectively.…”

“…The HCC TGR was calculated from multiphasic contrast-enhanced CTs or MRIs of patients who had two consecutive studies prior to any HCC therapy, at least 25 days apart [ 14 ] . Of the initial study cohort of 467 patients with the three etiologies of liver disease, 191 had at least two consecutive CTs or MRIs for TGR measurement from 1973–2019.…”

“…Recent TGR studies confirm heterogeneity in HCC, commonly seen in clinical practice [ 13 , 14 ] . However, despite current work assessing TGR, NAFLD patients continue to be under-represented.…”