Prognostic factors of hepatocellular carcinoma patients treated by transarterial chemoembolization

Abstract

We aim to investigate the clinical characteristics and prognostic factors of Hepatocellular Carcinoma (HCC) patients treated by transarterial chemoembolization (TACE) in Chinese cohort. A total of 2,493 HCC patients treated by TACE were included in this retrospective study. Patients were divided into the younger group (n=1,877) or the elderly group (n=616) based upon their ages (cut-off value of 60 y/o). Chi-square test or Wilcoxon rank-sum test was used to compare patients' characteristics. Univariate and multivariate analysis were used to determine prognostic factors. When compared with the younger group, the elderly group had lower male/female ratio and family liver disease history ratio, as well as advanced stage or Child-Pugh grade B patients. The median survival time was 8 months and 27 months for the younger and the elderly group, respectively. The 1-, 2-, and 3-year survival rates in the younger group and the elderly group were 31.82%, 12.5%, 6.53%, and 84.66%, 53.28%, 28.39%, respectively. Multivariate analysis showed that HBV infection, AFP value, TNM stage, Child-Pugh class, portal vein tumor thrombus (PVTT) and tumor number were independent prognostic factors for the younger patients; the elderly ones had similar independent prognostic factors except for HBV infection. The elderly group had lower male/female ratio and family history ratio, as well as advanced stage or Child-Pugh grade B patients. The elderly seems to have better prognosis than the younger ones, which is probably related to the fact that the elderly have lower tumor burden and better liver function.

Keywords: Clinical characteristics; TACE; hepatocellular carcinoma; prognostic factor.

Figure 1

Overall survival rates of the younger (n=1,877) and the elderly patients (n=616) treated by TACE. The 1-, 2-, and 3-year survival rates in the younger group and the elderly group were 31.82%, 12.5%, 6.53%, and 84.66%, 53.28%, 28.39%, respectively. P-values were calculated by the log-rank test.

Figure 2

Independent prognostic factors determined by the Multiple Cox regression analysis. Multivariate analysis showed that HBV infection, AFP value, TNM stage, Child-Pugh class, PVTT and tumor number were independent prognostic factors for the younger patients; among which PVTT had the highest HR of 3.684. AFP value, TNM stage, Child-Pugh class, PVTT and tumor number were independent prognostic factors for the elderly peoples; among which TNM stage IV had the highest HR of 2.603.