Prognostic factors of survival during hepatocellular carcinoma

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Published Sep 17, 2018
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Vol. 96 No. 6 (2018): Issue Jun 2018

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Norsaf Bibani
Dorra Trad
Meriam Sabbah
Asma Ouakaa
Héla Elloumi
Dalila Gargouri
Service de Gastro-entérologie Hôpital H. Thameur Tunis
Jamel Kharrat

Abstract

Introduction: Despite advances in diagnostic and therapeutic means,mortality of hepatocellular carcinoma (HCC) on liver cirrhosis remainsheavy in the absence of curative treatment.The aim of our study was toevaluate survival and to identify prognostic factors during HCC.
Patients and methods: A mono centric retrospective study over a period of13 years (January 2002-October 2015), including all patients with HHConcirrhotic liver was performed. Survival analysis was performed accordingto the Kaplan-Meier method. The prognostic factors of survival weredetermined by the Log Rank test.
Results: Ninety four patients wereincluded (meanage 66.18 years, sexratio 1.65). Cirrhosiswassecondary to hepatitis B or C in 73.6%).
Twentytwo patients responded to the MILAN criteria. Cirrhosiswasrated Child A,B and C in 30.9%, 46.8% and 22.3% of patients, respectively. A
Curativetreatment was possible for only 10 patients (11.2%). In our study, meansurvival was 15.1 months and overall survival at 1 year and 2 years were25.5% and 21.3%, respectively. Nine factors associated with shortersurvival were identified : a Child-Pugh stage B or C; the absence ofscreening; an AFP level of> 400ng / ml; the existence of vascularthrombosis; a CHC evolved according to the classification of Milan; anOKUDA III score; CLIP score ≥ 3; a BCLC stage C or D; palliative orsymptomatic treatment.
Conclusion: Although the best treatment of HCC remainspreventive, theuse of new prognostic scores couldimprove the management of patientsifintegrated in therapeuticalgorithms.

Keywords:

Hepatocellularcarcinoma, cirrhosis, survival,

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