BACKGROUND: This hospital-based analysis was conducted to identify prognostic factors of hepatocellular carcinoma (HCC) in a hepatitis B virus endemic area. METHODS: A total of 6381 HCC cases, diagnosed from 1986 to 2002, were enrolled, and 2890 (42.3%) of them were not treated. Survival rates were analyzed by correlation with the national mortality databank. Missing data and correlations among prognostic factors were considered in the analysis. RESULTS: The overall 1-year, 3-year, 5-year, and 7-year survival rates were 44.3%, 24.9%, 17.1%, and 13%, respectively. Multivariate analysis revealed that the independent factors influencing survival were the initial treatment modality, degree of liver function impairment, hepatitis B surface antigen positivity, tumor status, and alpha-fetoprotein. Besides these well-known prognostic factors, high alanine aminotransferase (ALT) levels and a high aspartate aminotransferase (AST)/ALT ratio were identified as independent poor prognostic factors. CONCLUSIONS: This study, which considered untreated cases, missing data, and correlations between variables and official survival data sets, provides a large-scale comprehensive survival analysis. According to our results, high ALT and high AST/ALT were independent poor prognostic factors. Therefore, viral activity should be controlled in HCC patients, and patients with elevated AST/ALT ratios should be carefully monitored.
BACKGROUND: This hospital-based analysis was conducted to identify prognostic factors of hepatocellular carcinoma (HCC) in a hepatitis B virus endemic area. METHODS: A total of 6381 HCC cases, diagnosed from 1986 to 2002, were enrolled, and 2890 (42.3%) of them were not treated. Survival rates were analyzed by correlation with the national mortality databank. Missing data and correlations among prognostic factors were considered in the analysis. RESULTS: The overall 1-year, 3-year, 5-year, and 7-year survival rates were 44.3%, 24.9%, 17.1%, and 13%, respectively. Multivariate analysis revealed that the independent factors influencing survival were the initial treatment modality, degree of liver function impairment, hepatitis B surface antigen positivity, tumor status, and alpha-fetoprotein. Besides these well-known prognostic factors, high alanine aminotransferase (ALT) levels and a high aspartate aminotransferase (AST)/ALT ratio were identified as independent poor prognostic factors. CONCLUSIONS: This study, which considered untreated cases, missing data, and correlations between variables and official survival data sets, provides a large-scale comprehensive survival analysis. According to our results, high ALT and high AST/ALT were independent poor prognostic factors. Therefore, viral activity should be controlled in HCC patients, and patients with elevated AST/ALT ratios should be carefully monitored.
Authors: G Fattovich; G Giustina; F Degos; G Diodati; F Tremolada; F Nevens; P Almasio; A Solinas; J T Brouwer; H Thomas; G Realdi; R Corrocher; S W Schalm Journal: J Hepatol Date: 1997-07 Impact factor: 25.083
Authors: J M Llovet; J Bustamante; A Castells; R Vilana; M del C Ayuso; M Sala; C Brú; J Rodés; J Bruix Journal: Hepatology Date: 1999-01 Impact factor: 17.425
Authors: T Itoshima; K Kawaguchi; M Ukida; T Ito; S Hattori; M Kitadai; H Ogawa; S Mizutani; K Kita; R Tanaka Journal: Acta Med Okayama Date: 1984-04 Impact factor: 0.892
Authors: Asmaa M Zahran; Zeinab Albadry M Zahran; Omnia El-Badawy; Mona H Abdel-Rahim; Wageeh A M Ali; Amal Rayan; Muhammad Abbas El-Masry; Mohamed A A Abozaid; Helal F Hetta Journal: Immunol Res Date: 2019-06 Impact factor: 2.829