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Volume 40 Issue 10
Oct.  2024
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Article Navigation >  Journal of Clinical Hepatology  > 2024  >  40(10): 2019-2026

Clinical features and prognosis of hepatocellular carcinoma： A single-center study of 850 cases

DOI: 10.12449/JCH241015
  • 1.

    Institute of Liver Diseases，Hubei Key Laboratory of Theoretical and Applied Research of Liver and Kidney in Traditional Chinese Medicine，Hubei Provincial Hospital of Traditional Chinese Medicine，Wuhan 430061，China

  • 2.

    The Affiliated Hospital of Hubei University of Chinese Medicine，Wuhan 430061，China

  • 3.

    Hubei Academy of Chinese Medicine，Wuhan 430074，China

  • 4.

    College of Traditional Chinese Medicine，Hubei University of Chinese Medicine，Wuhan 430065，China

Research funding:

Hubei Provincial Major R & D Program Projects (2023BCB126);

Public Health Leading Talents Training Program of Hubei Province (E weitong ［2021］ No.73)

More Information
  • Corresponding author: TAO Junxiu， 2547467429@qq.com （ORCID： 0000-0003-2172-8925）
  • Received Date: 2024-02-18
  • Accepted Date: 2024-04-02
  • Published Date: 2024-10-25
    Abstract
  •   Objective  To investigate the clinical features and prognosis of hepatocellular carcinoma （HCC）.  Methods  Medical records were collected from 850 HCC patients who were admitted to Hubei Provincial Hospital of Traditional Chinese Medicine from December 2014 to May 2022， and their clinical and prognostic features were analyzed. The chi-square test were used for comparison of categorical data between groups； the Kaplan-Meier method was used to calculate survival time and survival rate， and the log-rank test was used for comparison of survival time based on baseline features.  Results  Among the 850 HCC patients， male patients accounted for 82.6%， and the median age at initial diagnosis was 58.0 （49.0， 66.0） years， with the highest proportion of patients aged 50 ‍—‍ 69 years （59.8%）. The patients with HBV infection accounted for the highest proportion of 77.4%； at initial diagnosis， 49.2% of the patients had portal vein tumor thrombus， and 20.2% of the patients had extrahepatic metastasis， among which pulmonary metastasis accounted for the highest proportion of 44.2% （76/172）. The patients with Barcelona Clinic Liver Cancer （BCLC） stage A （0）， B， C， and D HCC accounted for 20.4%， 22.5%， 41.5%， and 15.6%， respectively. There was a significant difference in the distribution of BCLC stages between different groups based on sex （χ2=16.631， P=0.001）， age （χ2=24.261， P=0.019）， place of residence （χ2=39.776， P<0.001）， presence or absence of viral hepatitis （χ2=8.338， P=0.040）， and presence or absence of regular antiviral therapy before initial diagnosis （χ2=26.140， P<0.001）. Follow-up was performed for 489 patients till death， with a median survival time of 19.99 months （95% confidence interval ［CI］： 14.86 ‍—‍ 25.12）， and the 1-， 3-， 5-， and 10-year cumulative survival rates were 60.7%， 39.9%， 29.4%， and 22.7%， respectively. There was a significant difference in survival time between different groups based on age （χ2=13.452， P=0.009）， history of viral hepatitis （χ2=6.123， P=0.013）， regular antiviral therapy before initial diagnosis （χ2=15.505， P<0.001）， comorbidity with type 2 diabetes （χ2=9.820， P=0.002）， the number of tumors （χ2=57.713， P<0.001）， maximum tumor diameter （χ2=41.862， P<0.001）， portal vein tumor thrombus （χ2=293.909， P<0.001）， extrahepatic metastasis at initial diagnosis （χ2=118.329， P<0.001）， BCLC stage （χ2=465.638， P<0.001）， surgical resection （χ2=78.86， P<0.001）， local treatment （χ2=36.216， P<0.001）， immune checkpoint inhibitor treatment and/or anti-tumor angiogenesis therapy （χ2=7.182， P=0.007）， traditional Chinese medicine decoction treatment （χ2=30.050， P<0.001）， and comprehensive treatment regimens （χ2=13.221， P=0.004）. Progression-free survival （PFS） was recorded for 259 patients （30.5%）， with a median PFS of 10.98 months （95%CI： 8.54 ‍—‍ 13.42）.  Conclusion  HCC patients exhibit epidemiological characteristics in terms of sex， age， place of residence， presence or absence of viral hepatitis， regular antiviral therapy before initial diagnosis， tumor characteristics， treatment modality， and prognosis， with a low early detection rate and a short overall survival time， and therefore， it is urgent to perform early screening， early diagnosis， and early treatment.

     

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