Prognostic Factors for Hepatocellular Carcinoma: 5 Years’ Experience at the National Cancer Institute: A Retrospective Cohort Study

Abstract

Background: Hepatocellular carcinoma is a great problem that poses a huge burden upon any healthcare system. In Egypt it has shown a doubling in its incidence rate. This study intended to assess the different prognostic factors for the overall survival of HCC patients in Egypt. Study Design: This is a retrospective patients’ charts review of all patients (561) admitted to the National Cancer Institute (NCI), Cairo University with HCC from January 2007 to December 2011. The main outcome measures were the median overall survival. Also, all demographics, clinicopathological variables, laboratory data were tested as prognostic factors for the overall survival. Results: The median overall survival of our patients was seven months. The overall actuarial probability of survival during the follow-up period was 65% of patients at six months, 25% of patients at 12 months, 11% of patients at 18 months, and only 3% of patients at 24 months. In our study, a broad range of clinical, laboratory, tumor parameters, and demographic data of patients had shown statistical significance in univariate analysis. However, when all these significant factors in the univariate analysis were further analyzed by stepwise multivariate regression analysis which revealed that only age less than 60, non-symptomatic cases, AFP less than 400, no PV thrombosis, no portal HTN, no ascites, no metastasis and potentially curative therapy were prognostic factors for the overall survival. Conclusion: Among all detected prognostic factors, only, management therapy is modifiable, other factors are non-modifiable. Thus, for HCC, the earlier the diagnosis and intervention, the better is the prognosis and outcome. Therefore, US screening and follow-up of high-risk groups are a must for early diagnose and better outcome.