Related Experiment Video
Updated: Mar 25, 2026
A Three-Dimensional Spheroid Model to Investigate the Tumor-Stromal Interaction in Hepatocellular Carcinoma
Published on: September 30, 2021
The Charlson Comorbidity Index is an Independent Prognostic Factor for Treatment-Naïve Hepatocellular Carcinoma
Insights
High comorbidity in hepatocellular carcinoma (HCC) patients with extrahepatic metastases is linked to reduced anti-cancer treatment and poorer overall survival. Comprehensive comorbidity assessment is crucial for treatment decisions.
Area of Science:
- Hepatobiliary Oncology
- Clinical Oncology
- Cancer Epidemiology
Background:
- Hepatocellular carcinoma (HCC) with extrahepatic metastases presents a significant clinical challenge.
- Understanding factors influencing survival in advanced HCC is critical for patient management.
Purpose of the Study:
- To investigate the relationship between comorbidity, anti-cancer treatment, and overall survival in patients with stage IV HCC and extrahepatic metastases.
- To identify prognostic factors for overall survival in this patient population.
Main Methods:
- Retrospective analysis of 57 treatment-naïve stage IV HCC patients diagnosed between 2007 and 2010.
- Assessment of comorbidity using the Charlson Comorbidity Index (CCI) and Kaplan-Feinstein index.
- Statistical analysis of associations between comorbidity, demographics, treatment, and overall survival.
Main Results:
- Higher comorbidity (CCI ≥ 2) was associated with reduced anti-cancer treatment administration (P < 0.001).
- Neither CCI ≥ 2 nor anti-cancer therapy showed a significant survival benefit in univariate analysis (P = 0.174).
- Multivariate analysis identified CCI ≥ 2 as the sole independent negative prognostic factor for overall survival (P = 0.043).
Conclusions:
- Pre-treatment comorbidity significantly impacts overall survival in advanced HCC patients.
- Comorbidity influences the likelihood of receiving anti-cancer therapy.
- A thorough comorbidity evaluation is recommended before initiating treatment for HCC with extrahepatic metastases.
Background/Aims:
This study aimed to investigate the association between comorbidity, anti-cancer treatment, and overall survival in patients with hepatocellular carcinoma (HCC) with extrahepatic metastases.
Methodology:
We retrospectively analyzed data from 57 patients diagnosed as having treatment-naïve stage IV HCC with extrahepatic metastases between 2007 and 2010. Comorbidity was assessed using two scoring systems, the Charlson comorbidity index (CCI) and the Kaplan-Feinstein index. Associations between comorbidity, demographic variables, treatment modality, and overall survival were analyzed.
Results:
Univariate analysis showed that a CCI of ≥ 2 (P = 0.017), an Okuda score of II/III (P = 0.026), and the use of anti-cancer therapy (P = 0.039) was associated with overall survival. Fewer patients with a CCI of ≥ 2 received treatment (P < 0.001), and anti-cancer treatment of any modality did not show a survival benefit in these patients (P = 0.174). The multivariate analysis showed that a CCI of ≥ 2 was the only independent prognostic factor for overall survival (P = 0.043).
Conclusions:
The pre-treatment comorbidity status played an important role in overall survival because of its association with the administration of anti-cancer therapy. Therefore, comprehensive evaluation of comorbidities before treatment is recommended for HCC patients with extrahepatic metastases.
