Modifiable Prognostic Factors of Hepatocellular Carcinoma in Patients with Non-Surgical Treatment.

Jen-Hao Yeh, Chao-Hung Hung, Jing-Houng Wang, Chien-Hung Chen, Kwong-Ming Kee, Chung-Mou Kuo, Yi-Hao Yen, Yu-Fan Cheng, Yen-Yang Chen, Hsuan-Chi Hsu, Sheng-Nan Lu

Index: PLoS ONE 10 , e0144893, (2015)

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Abstract

Current hepatocellular carcinoma (HCC) staging systems only use baseline characteristics to predict outcome. We aimed to explore modifiable factors of the prognosis in HCC cases had undergone non-surgical treatment.All HCC cases in Kaohsiung Chang Gung Memorial hospital in southern Taiwan from 2002 to 2012 must met all below criteria: (1) met international diagnostic guidelines, (2) underwent the initial treatments in our hospital (3) treated by non-surgical treatment modalities and (4) survived more than two years, with follow-up time longer than five years.A total 698 patients were enrolled: 451 (24.6%, group A) survivied between 2 to 5 years, and 247 (13.5%, group B) had survived > 5 years. Aside from liver function reserve and BCLC stages, four interventional factors: initial treatment modality, outcomes of 1st or 2nd treatment, and anti-viral therapy to chronic viral hepatitis were associated with prognosis. After propensity score matching, multiple logistic regression of 223 well-matched pairs showed that recurrence within one year after 1st treatment (OR: 2.17, 95% CI: 1.35-3.48), incomplete 2nd treatment (2.01, 1.27-3.17) and absence of anti-viral agents (1.68, 1.09-2.59) were independent poor prognostic factors.Complete treatment and anti-viral agents to chronic hepatitis were both independent modifiable prognostic factors of HCC patients had undergone non-surgical treatment. Based on these findings, timely treatment to achieve maximal locoregional control and anti-viral treatment should be provided as possible.