Gender difference in clinicopathologic features and survival of patients with hepatocellular carcinoma

To determine the influence of gender on the clinicopathologic characteristics and survival of patients with hepatocellular carcinoma (HCC).

A retrospective analysis of medical records was performed in 299 patients with HCC and their clinicopathologic features and survival were compared in relation to gender.

There were 260 male (87%) and 39 female patients (13%), with a male-to-female ratio of 6.7:1. Female patients had lower mean serum bilirubin levels (P=0.03), lower proportion of alcohol abuse (P=0.002), smaller mean tumor size (P=0.02), more frequent nodular type but less frequent massive and diffuse types of HCC (P=0.01), were less advanced in Okuda's staging (P=0.04), and less frequently associated with venous invasion (P=0.03). The median survivals in females (14 mo) were significantly longer than that of male patients (4 mo) (P=0.004, log-rank test). Multivariate analysis demonstrated that high serum alpha-fetoprotein levels, venous invasion, extrahepatic metastasis and lack of therapy were independent factors related to unfavorable prognosis. However, gender did not constitute a predictive variable associated with patient survival.

Female patients tend to have higher survival rates than males. These differences were probably due to more favorable pathologic features of HCC at initial diagnosis and greater likelihood to undergo curative therapy in female patients.