中文English
ISSN 1001-5256 (Print)
ISSN 2097-3497 (Online)
CN 22-1108/R
Issue 7
Jul.  2018

Clinical features of patients with Barcelona Clinic Liver Cancer stage C primary liver cancer and related prognostic factors: An analysis of 140 cases

DOI: 10.3969/j.issn.1001-5256.2018.07.019
Research funding:

 

  • Received Date: 2017-12-11
  • Published Date: 2018-07-20
  • Objective To investigate the clinical features of patients with Barcelona Clinic Liver Cancer ( BCLC) stage C primary liver cancer ( PLC) and related prognostic factors. Methods A retrospective analysis was performed for the clinical data of 140 patients with BCLC stage C PLC who were admitted to Beijing Ditan Hospital, Capital Medical University, from October 2008 to December 2015. The Kaplan-Meier method was used for survival analysis, and the log-rank test was used for univariate analysis. The multivariate Cox proportional hazards model was used to analyze prognostic factors according to forward stepwise regression based on maximum likelihood estimation. Results Most of the 140 patients were male, and the male/female ratio was 6∶ 1. The three most common initial symptoms of PLC were abdominal pain or liver area pain, weakness, and abdominal distension. The median survival time was 6 months, and the median follow-up time was 10 months ( 1-80 months) . The 1-year survival rate of these patients was 22. 14%. The univariate analysis showed that Child-Pugh class, the type of portal vein tumor thrombus, tumor number, tumor morphology, tumor diameter, aspartate aminotransferase/alanine aminotransferase ( AST/ALT) ratio, and use or non-use of transcatheter arterial chemoembolization ( TACE) were associated with prognosis ( χ2= 6. 215, 19. 609, 8. 849, 11. 122, 11. 571, 7. 438, 30. 511, and 10. 690, all P < 0. 05) . The multivariate analysis showed that Child-Pugh class ( odds ratio [OR]= 1. 524, 95% confidence interval [CI]: 1. 011-2. 297, P = 0. 044) , tumor diameter ( OR = 1. 803, 95%CI: 1. 097-2. 964, P = 0. 020) , and AST/ALT ratio ( OR = 1. 769, 95% CI: 1. 301-2. 406, P < 0. 001) were independent risk factors for the prognosis of advanced PLC, while the use of TACE was a protective factor ( OR = 0. 598, 95% CI: 0. 363-0. 985, P = 0. 043) .Conclusion Advanced PLC has poor prognosis and short median survival time. A more accurate survival benefit analysis should be performed based on adverse prognostic factors to guide the selection of therapeutic paradigms in clinical practice. Increased AST/ALT ratio should also be taken seriously.

     

  • [1]TORRE LA, BRAY F, SIEGEL RL, et al.Global cancer statistics, 2012[J].CA Cancer J Clin, 2015, 65 (2) :87-108.
    [2]Ministry of Health of the People's Republic of China.Diagnosis, management, and treatment of hepatocellular carcinoma (V2011) [J].J Clin Hepatol, 2011, 27 (11) :1141-1159. (in Chinese) 中华人民共和国卫生部.原发性肝癌诊疗规范 (2011年版) [J].临床肝胆病杂志, 2011, 27 (11) :1141-1159.
    [3]LENCIONI R, LLOVET JM.Modified RECIST (mRECIST) assessment for hepatocellular carcinoma[J].Semin Liver Dis, 2010, 30 (1) :52-60.
    [4]HSU C, SHEN YC, CHENG CC, et al.Geographic difference in survival outcome for advanced hepatocellular carcinoma:Implications on future clinical trial design[J].Contemp Clin Trials, 2010, 31 (1) :55-61.
    [5]TINKLE CL, HAAS-KOGAN D.Hepatocellular carcinoma:Natural history, current management, and emerging tools[J].Biologics, 2012, 6:207-219.
    [6]ZHAO RR, DENG YD, YUAN H.Epidemiological and clinical features of primary liver cancer:An analysis of 236 patients[J].J Clin Hepatol, 2016, 32 (8) :1538-1542. (in Chinese) 赵荣荣, 邓永东, 袁宏.236例原发性肝癌患者流行病学及临床特点分析[J].临床肝胆病杂志, 2016, 32 (8) :1538-1542.
    [7]LU LG.Advances in early screening and diagnosis of hepatocellular carcinoma[J].J Clin Hepatol, 2017, 33 (7) :1257-1261. (in Chinese) 陆伦根.原发性肝癌的早期筛查及诊断[J].临床肝胆病杂志, 2017, 33 (7) :1257-1261.
    [8] CENTER MM, JEMAL A.International trends in liver cancer incidence rates[J].Cancer Epidemiol Biomarkers Prev, 2011, 20 (11) :2362-2368.
    [9]de MARIA N, MANNO M, VILLA E.Sex hormones and liver cancer[J].Mol Cell Endocrinol, 2002, 193 (1-2) :59-63.
    [10] MARRERO JA, KUDO M, BRONOWICKI JP.The challenge of prognosis and staging for hepatocellular carcinoma[J].Oncologist, 2010, 15 Suppl 4:23-33.
    [11]LIU JY, JIN J, GUAN S, et al.The effect of hepatic function status on the survival time in patients with advanced hepatocellular carcinoma after transcatheter arterial chemoembolization[J].J Intervent Radiol, 2013, 22 (3) :247-250. (in Chinese) 刘纪营, 金洁, 管生, 等.肝功能状态对晚期肝癌介入治疗生存期的影响[J].介入放射学杂志, 2013, 22 (3) :247-250.
    [12] XUE TC, XIE XY, ZHANG L, et al.Transarterial chemoembolization for hepatocellular carcinoma with portal vein tumor thrombus:A meta-analysis[J].BMC Gastroenterol, 2013, 13:60.
    [13]RAOUL JL, BRUIX J, GRETEN TF, et al.Relationship between baseline hepatic status and outcome, and effect of sorafenib on liver function:SHARP trial subanalyses[J].J Hepatol, 2012, 56 (5) :1080-1088.
    [14]CHENG AL, GUAN Z, CHEN Z, et al.Efficacy and safety of sorafenib in patients with advanced hepatocellular carcinoma according to baseline status:Subset analyses of the phase III Sorafenib AsiaPacific trial[J].Eur J Cancer, 2012, 48 (10) :1452-1465.
    [15]WU ZY.Risk factors of prognosis in patients with advanced liver cancer after transcather arterial chemoembolization[J].J Pract Hepatol, 2015, 18 (4) :427-429. (in Chinese) 吴照宇.中、晚期肝癌介入治疗预后的影响因素分析[J].实用肝脏病杂志, 2015, 18 (4) :427-429.
    [16]NIU ZJ, MA YL, KANG P, et al.Transarterial chemoembolization compared with conservative treatment for advanced hepatocellular carcinoma with portal vein tumor thrombus:Using a new classification[J].Med Oncol, 2012, 29 (4) :2992-2997.
    [17]NISHIKAWA H, OSAKI Y, KITA R, et al.Comparison of transcatheter arterial chemoembolization and transcatheter arterial chemotherapy infusion for patients with intermediate-stage hepatocellular carcinoma[J].Oncol Rep, 2014, 31 (1) :65-72.
    [18] XIANG Y, YANG T, PANG BY, et al.The progress and prospects of putative biomarkers for liver cancer stem cells in hepatocellular carcinoma[J].Stem Cells Int, 2016, 2016:7614971.
    [19] MORIMOTO M, NUMATA K, MORIYA S, et al.Inflammationbased prognostic score for hepatocellular carcinoma patients on sorafenib treatment[J].Anticancer Res, 2012, 32 (2) :619-623.
    [20]CHANGCHIEN CS, CHEN CL, YEN YH, et al.Analysis of 6381hepatocellular carcinoma patients in southern Taiwan:Prognostic features, treatment outcome, and survival[J].J Gastroenterol, 2008, 43 (2) :159-170.
    [21]CHAO Y, CHUNG YH, HAN G, et al.The combination of transcatheter arterial chemoembolization and sorafenib is well tolerated and effective in Asian patients with hepatocellular carcinoma:Final results of the START trial[J].Int J Cancer, 2015, 136 (6) :1458-1467.
    [22]FU QH, ZHANG Q, BAI XL, et al.Sorafenib enhances effects of transarterial chemoembolization for hepatocellular carcinoma:A systematic review and meta-analysis[J].J Cancer Res Clin Oncol, 2014, 140 (8) :1429-1440.
    [23] BRUIX J, CHENG AL, MEINHARDT G, et al.Prognostic factors and predictors of sorafenib benefit in patients with hepatocellular carcinoma:Analysis of two phase III studies[J].J Hepatol, 2017, 67 (5) :999-1008.
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