Clinical Analysis of Prognostic Factors in Hepatocellular Carcinoma

ABSTRACT

PURPOSE: Although the resectability of hepatocellular carcinoma has increased due to recent advances in diagnostic methods and surgical techniques, the long-term results are unsatisfactory due to their invasiveness and frequent association with cirrhosis. This study was designed to identify the prognostic factors affecting the long term survival and recurrence of tumors in patients having undergone a hepatic resection for a hepatocellular carcinoma. METHODS: Between June 1996 and March 2002, 51 consecutive patients underwent a hepatic resection for a hepatocelluar carcinoma at the Inha University Hospital. The overall cumulative and disease free survival rates for these patients were analysed. Twenty-five clinicopathological factors were evaluated by univariate and multivariate analyse to determine any significant prognostic factors. RESULTS: The cumulative 1, 3 and 5-year survival rates were 84, 70 and 58%, respectively. There were 26 recurrences, and the 1, 3 and 5-year disease free cumulative survival rates were 60, 53 and 31%, respectively. From the univariate analysis, all the factors associated with ascites (P=0.0000), total bilirubin (P=0.0015), albumin (P=0.0271), prothrombin time (P=0.0392), HBe antigen (P=0.0283), Child classification (P=0.0000), celluar differentiation (P=0.0043) were found to correlate with the overall survival. From a Cox regression analysis, the HBe antigen (P=0.019), ascites (P=0.028) were found to be independent prognostic factors of the overall survival. The only factor with an independent effect on disease free survival was the HBe antigen (P=0.037). CONCLUSION: Because prognosis of HBe antigen-positive patients with ascites is poor, frequent postoperative follow up surveys in these patients are needed.