Prognostic factors of hepatocellular carcinoma in the west: A multivariate analysis in 206 patients

Authors

  • Xavier Calvet,

    1. Liver Unit and Departments of Radiology and Pathology, Hospital Clínic i Provincial, Barcelona 08036, Spain
    Search for more papers by this author
    • Dr. Calvet had a research grant from the Hospital Clinic i Provincial of Barcelona.

  • Jordi Bruix M.D.,

    Corresponding author
    1. Liver Unit and Departments of Radiology and Pathology, Hospital Clínic i Provincial, Barcelona 08036, Spain
    • Liver Unit, Hospital Clinic i Provincial, C/Villarroel, 170, Barcelona 08036, Spain
    Search for more papers by this author
  • Pere Ginés,

    1. Liver Unit and Departments of Radiology and Pathology, Hospital Clínic i Provincial, Barcelona 08036, Spain
    Search for more papers by this author
  • Concepció Bru,

    1. Liver Unit and Departments of Radiology and Pathology, Hospital Clínic i Provincial, Barcelona 08036, Spain
    Search for more papers by this author
  • Manel Sole,

    1. Liver Unit and Departments of Radiology and Pathology, Hospital Clínic i Provincial, Barcelona 08036, Spain
    Search for more papers by this author
  • Ramón Vilana,

    1. Liver Unit and Departments of Radiology and Pathology, Hospital Clínic i Provincial, Barcelona 08036, Spain
    Search for more papers by this author
  • Joan Rodés

    1. Liver Unit and Departments of Radiology and Pathology, Hospital Clínic i Provincial, Barcelona 08036, Spain
    Search for more papers by this author

Abstract

To investigate the prognostic factors in Western patients with hepatocellular carcinoma, 206 patients with confirmed diagnoses of hepatocellular carcinoma were studied in terms of survival. All patients were diagnosed between 1983 and 1987. A multivariate survival analysis (Cox regression model) using clinical, biochemical, ultrasonographical and pathological data obtained at diagnosis disclosed that bilirubin (p = 0.0001), ascites (p = 0.0001), toxic syndrome (defined by the presence of weight loss > 10% premorbid weight, malaise and anorexia) (p = 0.009), blood urea nitrogen (p = 0.025), tumor size (p = 0.001), γ-glutamyltranspeptidase (p = 0.0006), age (p = 0.0005), serum sodium (p = 0.003) and presence of metastases (p = 0.002) were independent predictors of survival. According to the contribution of each of these factors to the final model, a prognostic index was constructed allowing division of patients in different groups according to their relative risk of death: RRD = EXP (Age × 0.03 + Ascites × 0.8281 + BUN × 0.0137 + Serum sodium × (− 0.0538) + γ-Glutamyltranspeptidase × 0.0019 + Bilirubin × 0.0734 + Tumor size × 0.33 + Toxic syndrome × 0.4965 + Metastases × 0.55).

These results facilitate the stratification of hepatocellular carcinoma patients to design and evaluate future controlled trials. (HEPATOLOGY 1990;12:753–760).

Ancillary