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Hepatocellular carcinoma cases with five-year survival and prognostic factors affecting the survival time
Insights
Early-stage hepatocellular carcinoma (HCC) patients with mild liver cirrhosis have better long-term survival. Treatment and clinical stage significantly impact survival rates in HCC patients.
Area of Science:
- Hepatology
- Oncology
- Medical Statistics
Background:
- Hepatocellular carcinoma (HCC) is a significant global health concern.
- Survival rates for HCC vary widely based on disease stage and treatment.
- Understanding prognostic factors is crucial for improving patient outcomes.
Purpose of the Study:
- To analyze survival rates in HCC patients based on clinical stage and treatment.
- To identify key factors influencing long-term survival in HCC.
- To evaluate the effectiveness of different treatment modalities for HCC.
Main Methods:
- Retrospective analysis of 178 HCC patients diagnosed between 1980 and 1994.
- Kaplan-Meier survival analysis and logrank tests to compare survival rates.
- Cox proportional hazards model to identify significant prognostic factors.
Main Results:
- Five-year survival rates were significantly different across HCC stages (I: 38.1%, II: 31.8%, IVA: 3.9%).
- Hepatic resection (53.7%) showed higher 5-year survival than percutaneous ethanol injection (38.7%) and transcatheter hepatic arterial embolization (13.5%).
- Clinical stage, tumor size, and patient age were significant predictors of survival.
Conclusions:
- Early-stage HCC, particularly with mild liver cirrhosis, offers a better prognosis.
- Treatment modality and clinical stage are critical determinants of HCC patient survival.
- Prognostic factors like tumor size and age should be considered in HCC management.
Abstract:
Between 1980 and 1994, 178 patients were confirmed to have hepatocellular carcinoma (HCC) in our hospital. The 5-year survival rates in patients with HCC of stage I, II and IVA were 38.1%, 31.8% and 3.9%, respectively. No patient in stage III or IVB survived for more than four years. The 5-year survival rates of the patients treated by hepatic resection, ultrasonically guided percutaneous ethanol injection and transcatheter hepatic arterial embolization were 53.7%, 38.7% and 13.5%, respectively. The logrank test showed a significant difference in cumulative survival rates obtained in patients with HCC according to the tumor stage (p < 0.001) or principal treatment procedure (p < 0.001). Twelve patients survived for more than five years. We employed a Cox's proportional hazards model to estimate the factors significantly affecting the survival time. Variables with statistical significance were the clinical stage (p < 0.001), tumor size (maximal tumor diameter) (p < 0.001) and patient's age (p < 0.05). Conclusively, patients in the early stage of HCC associated with mild liver cirrhosis have a significantly better chance for long survival.