Current state and clinical outcome in Turkish patients with hepatocellular carcinoma
| Autor: | Filiz Akyuz, Fatih Besisik, Arzu Poyanli, Cetin Karaca, Ozlem Mutluay Soyer, Mine Gulluoglu, Sabahattin Kaymakoglu, Omer Ekinci, Bulent Baran, Asli Ormeci, Suut Gokturk, Kadir Demir, Sami Evirgen |
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| Přispěvatelé: | Baran, Bülent (ORCID 0000-0001-7966-2346 & YÖK ID 167583), Ekinci, Ömer, Örmeci, Aslı Çifcibaşı, Soyer, Özlem Mutluay, Göktürk, Suut, Evirgen, Sami, Poyanlı, Arzu, Güllüoğlu, Mine, Akyüz, Filiz, Karaca, Çetin, Demir, Kadir, Besisik, Fatih, Kaymakoğlu, Sabahattin, Koç University Hospital |
| Jazyk: | angličtina |
| Rok vydání: | 2018 |
| Předmět: |
medicine.medical_specialty
Cirrhosis Medicine Gastroenterology and hepatology Survival Hepatocellular carcinoma Alfa-fetoprotein Gastroenterology 03 medical and health sciences Liver disease 0302 clinical medicine Internal medicine medicine Retrospective Cohort Study Survival analysis Hepatology Proportional hazards model business.industry medicine.disease Prognosis Transplantation Treatment 030220 oncology & carcinogenesis 030211 gastroenterology & hepatology Liver function business Viral hepatitis |
| Zdroj: | World Journal of Hepatology |
| Popis: | Aim: To investigate clinical, etiological, and prognostic features in patients with hepatocellular carcinoma. Methods: Patients with hepatocellular carcinoma who were followed-up from 2001 to 2011 were included in the study. The diagnosis was established by histopathological and/or radiological criteria. We retrospectively reviewed clinical and laboratory data, etiology of primary liver disease, imaging characteristics and treatments. Child-Pugh and Barcelona Clinic Liver Cancer stage was determined at initial diagnosis. Kaplan-Meier survival analysis was done to find out treatment effect on survival. Risk factors for vascular invasion and overall survival were investigated by multivariate Cox regression analyses. Results: Five hundred and forty-five patients with hepatocellular carcinoma were included in the study. Viral hepatitis was prevalent and 68 patients either had normal liver or were non-cirrhotic. Overall median survival was 16 (13-19) mo. Presence of extrahepatic metastasis was associated with larger tumor size (OR = 3.19, 95% CI: 1.14-10.6). Independent predictor variables of vascular invasion were AFP (OR = 2.95, 95% CI: 1.38-6.31), total tumor diameter (OR = 3.14, 95% CI: 1.01-9.77), and hepatitis B infection (OR = 5.37, 95% CI: 1.23-23.39). Liver functional reserve, tumor size/extension, AFP level and primary treatment modality were independent predictors of overall survival. Transarterial chemoembolization (HR = 0.38, 95% CI: 0.28-0.51) and radioembolization (HR = 0.36, 95% CI: 0.18-0.74) provided a comparable survival benefit in the real life setting. Surgical treatments as resection and transplantation were found to be associated with the best survival compared with loco-regional treatments (log-rank, P < 0.001). Conclusion: Baseline liver function, oncologic features including AFP level and primary treatment modality determines overall survival in patients with hepatocellular carcinoma. NA |
| Databáze: | OpenAIRE |
| Externí odkaz: |
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