Objective. To determine the most important prognostic factors for survival in patients with hepatocellular carcinoma (HCC).
Materials and methods. Between 2010 and 2015 at Vilnius University Hospital “Santaros klinikos” 149 patients with histologically diagnosed HCC were retrospectively analyzed. Age, gender, etiology of cirrhosis, Child-Pugh classification, MELD score, serum alpha fetoprotein concentration (group I <20 kU/L, group II 20-399 kU/L and group III >400 kU/L), tumor size (group A <2 cm, group B 2-5 cm and group C >5 cm) and the number of tumors, were recorded. A treatment method was also evaluated: liver transplantation (LT), liver resection (LR), transarterial chemoembolization (TACE), percutaneous ethanol injection (PEI), radiofrequency ablation (RDA), combined therapy (CT) (LR+chemotherapy; resection+RDA), systemic chemotherapy with sorafenib, support ive care (SC). Data were analyzed by SPPS v.19. A p-value <0.05 was considered as statistically significant.
Results. Majority of patients were men (75%), patient’s mean age was 63.6±11.7 years (18-96 years). All patients in our study had liver cirrhosis. The etiology of cirrhosis was different, but hepatitis C virus infection accounted for most of the cases (61%). The median follow-up time was 12 months (1 month - 9 years) afrer diagnosis of HCC. Mean survival rate was 22.36±19.95 months. LR was performed for 43 patients (28.9%), 43 (28.9%) received sorafenib, 16 (10.7%) had only SC, RDA was performed for 18 (12.1%), TACE had 16 (10.7%), LT had 7 (4.7%), PEI had 3 (2%), and 3 patients (2%) were treated using CT. Mean survival (months±SD) was 48±20.8 for PEI; 35.7±25.7 for RDA; 34.3±18.9 for LT; 28±18.3 for CT; 25.9±23.6 for LR; 19.9±12.3 for TACE; 14.6±12.9 for sorafenib and 13.6±13.3 for SC. Survival was signifrcantly lower in patients with tumor size > 5 cm (p<0.001) and MELD score > 10 (p<0.001). Survival was significantly higher in patients who underwent PEI, RDA and LT (p<0.001), who had single nodule (p<0.001) or liver cirrhosis of Child-Pugh class A (p<0.001).
Conclusions. Survival was significantly higher in patients who underwent PEI, RDA and LT treatments. Tumor size, the number of tumors, MELD score, Child-Pugh class were the most important prognostic factors related to overall survival in patients with hepatocellular carcinoma.
