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Prognostic factor and risk stratification in hepatocellular carcinoma: insights from Cox regression and Kaplan-Meier

L C Nguyen1, D T M Luu, H T N Doan

  • 1Gastroenterology and Hepatology Center, Bach Mai Hospital, Giai Phong Road, Ha Noi, Vietnam. nguyenconglong@bachmai.edu.vn.

European Review for Medical and Pharmacological Sciences
|January 3, 2025
PubMed

Insights

Hepatocellular carcinoma (HCC) survival is impacted by Hepatitis C virus (HCV) infection, alcoholism, elevated alpha-fetoprotein (AFP), PIVKA-II, and Child-Pugh score. Identifying these prognostic factors aids personalized HCC treatment.

Area of Science:

  • Hepatology
  • Oncology
  • Clinical Research

Background:

  • Hepatocellular carcinoma (HCC) presents a major global health challenge, contributing significantly to disease and death.
  • Understanding prognostic factors is crucial for effective management and improved patient survival in HCC.

Purpose of the Study:

  • To conduct a comprehensive evaluation of prognostic factors influencing survival in patients diagnosed with HCC.
  • To identify key indicators for risk stratification and personalized treatment strategies in HCC.

Main Methods:

  • A cross-sectional study analyzed a cohort of 364 HCC patients (predominantly male, mean age 61.6 years).
  • Prognostic factors were identified using Cox regression and Kaplan-Meier survival analysis.

Main Results:

  • Significant mortality predictors included Hepatitis C virus (HCV) infection, alcoholism, elevated alpha-fetoprotein (AFP) and protein induced by vitamin K absence or antagonist-II (PIVKA-II) levels, and Child-Pugh score ≥ 8.
  • HCV-positive patients showed a hazard ratio (HR) of 2.25. Patients with PIVKA-II ≤ 125 mAU/mL had a 50% survival chance at 42 months.
  • One, two, and three-year survival rates were 73.6%, 44.5%, and 31.3%. Barcelona Clinic Liver Cancer (BCLC) stage B1 patients demonstrated better survival rates.

Conclusions:

  • The study identifies critical prognostic factors for HCC, enhancing risk stratification.
  • These findings support personalized treatment decisions, aiming to improve outcomes for HCC patients.
Abstract

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