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. 2022 Jan 8:15:393-406.
doi: 10.2147/IJGM.S338066. eCollection 2022.

Factors Influencing Overall Survival for Patients with Fibrolamellar Hepatocellular Carcinoma: Analysis of the Surveillance, Epidemiology, and End Results Database

Georgios Polychronidis  1 , Jincheng Feng  2 , Anastasia Murtha-Lemekhova  1 , Ulrike Heger  1 , Arianeb Mehrabi  1 , Katrin Hoffmann  1
Affiliations

Factors Influencing Overall Survival for Patients with Fibrolamellar Hepatocellular Carcinoma: Analysis of the Surveillance, Epidemiology, and End Results Database

Georgios Polychronidis et al. Int J Gen Med. .

Abstract

Background: The study aimed to develop a nomogram to predict overall survival (OS) for patients with FLC using a national database.

Methods: The Surveillance, Epidemiology, and End Results database of the National Cancer Institute was reviewed to identify FLC cases with histological confirmation between 2004 and 2014. Cox proportional hazards models were used to identify factors associated with OS. The validation of the nomogram was performed using concordance index (C-index) and calibration curves.

Results: Out of 170 cases with complete follow-up, 87 received surgery/ablation and 12 received transplantation with significantly higher OS than chemotherapy alone while transplantation combined with chemotherapy showed better survival than solely transplantation. The combination of surgery and chemotherapy showed worse OS than surgery alone. Survival was negatively influenced by T4 stadium (HR = 5.91), while young age and surgery were positive predictive factors. There was no influence of gender, ethnicity or nodal status on survival. The rate of AFP positivity was comparable with and without the presence of distal metastases.

Conclusion: FLC survival is greatly dependent upon appropriate surgical management irrespective of tumor stadium.

Keywords: SEER; carcinoma; fibrolamellar; hepatocellular.

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Conflict of interest statement

The authors have declared no conflicts of interest.

Figures

Figure 1
Figure 1
Overall survival plot.
Figure 2
Figure 2
Survival plot depending on surgery, no resection and transplantation.
Figure 3
Figure 3
Predictive survival nomogram.
Figure 4
Figure 4
Predicted 1-year (A), 3-year (B) and 5-year (C) survival based on the nomogram.
See this image and copyright information in PMC

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