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Keywords:

  • hepatocellular carcinoma (HCC);
  • hepatitis B virus (HBV);
  • HBV-DNA;
  • prognosis

Abstract

BACKGROUND

Hepatitis B virus (HBV) is closely linked to hepatocellular carcinoma (HCC). The objective of the current study was to identify the factors involved in the prognosis of patients with HBV-associated HCC using multivariate analysis.

METHODS

The current study included 74 patients with HBV-associated HCC who were admitted to Nagasaki University Hospital, Nagasaki, Japan, between 1983–1998. Of these, 13 patients underwent surgical tumor resection; 43 patients received nonsurgical treatment with transcatheter arterial embolization, percutaneous ethanol injection, or both; and 18 patients were followed without any active treatment. The significance of the patient's age; gender; history of blood transfusion; alcohol use; serum levels of alanine aminotransferase, α-fetoprotein, and HBV-DNA; number and size of liver tumors; clinical stage; and histologic diagnosis of HCC as prognostic factors was evaluated using univariate and multivariate analyses.

RESULTS

The 3-year, 5-year, and 10-year postdiagnosis cumulative survival rates were 36%, 21%, and 17%, respectively. Multivariate analysis identified the level of serum HBV-DNA and tumor size at diagnosis as independent and significant prognostic factors (P = 0.0022 and P = 0.0106, respectively). In addition, a low level of viremia was found to be associated with longer survival (P = 0.0057) even in patients who were negative for the hepatitis B e antigen.

CONCLUSIONS

The results of the current study suggest that viral load is a useful prognostic marker for HBV-related HCC and that HCC patients with a less favorable course appear either to clear the virus poorly or to have a greater level of virus production. Cancer 2002;94:2663–8. © 2002 American Cancer Society.

DOI 10.1002/cncr.10557