Abdelaziz Ashraf Omar, Elbaz Tamer Mahmoud, Shousha Hend Ibrahim, Ibrahim Mostafa Mohamed, Rahman El-Shazli Mostafa Abdel, Abdelmaksoud Ahmed Hosni, Aziz Omar Abdel, Zaki Hisham Atef, Elattar Inas Anwar, Nabeel Mohamed Mahmoud
Department Endemic Hepatogastroenterology, National Cancer Institute, Cairo University, Cairo, Egypt E-mail :
Asian Pac J Cancer Prev. 2014;15(9):3915-20. doi: 10.7314/apjcp.2014.15.9.3915.
Hepatocellular carcinoma (HCC) is a dismal tumor with a high incidence, prevalence and poor prognosis and survival. Management of HCC necessitates multidisciplinary clinics due to the wide heterogeneity in its presentation, different therapeutic options, variable biologic behavior and background presence of chronic liver disease. We studied the different prognostic factors that affected survival of our patients to improve future HCC management and patient survival.
This study is performed in a specialized multidisciplinary clinic for HCC in Kasr El Eini Hospital, Cairo University, Egypt. We retrospectively analyzed the different patient and tumor characteristics and the primary mode of management applied to our patients. Further analysis was performed using univariate and multivariate statistics.
During the period February 2009 till February 2013, 290 HCC patients presented to our multidisciplinary clinic. They were predominantly males and the mean age was 56.5 ± 7.7 years. All cases developed HCC on top of cirrhosis that was mainly due to HCV (71%). Most of our patients were Child-Pugh A (50%) or B (36.9%) and commonly presented with small single lesions. Transarterial chemoembolization was the most common line of treatment used (32.4%). The overall survival was 79.9% at 6 months, 54.5% at 1 year and 22.4% at 2 years. Serum bilirubin, site of the tumor and type of treatment were the significant independent prognostic factors for survival.
Our main prognostic variables are the bilirubin level, the bilobar hepatic affection and the application of specific treatment (either curative or palliative). Multidisciplinary clinics enhance better HCC management.
肝细胞癌（HCC）是一种预后差、发病率和患病率高的恶性肿瘤。由于其临床表现广泛异质性、不同治疗选择、可变生物学行为以及慢性肝病背景的存在，HCC的管理需要多学科门诊。我们研究了影响患者生存的不同预后因素，以改善未来HCC的管理和患者生存情况。
本研究在埃及开罗大学艾因夏姆斯医院的HCC多学科专科门诊进行。我们回顾性分析了不同患者和肿瘤特征以及应用于患者的主要治疗方式。使用单变量和多变量统计进行进一步分析。
在2009年2月至2013年2月期间，290例HCC患者就诊于我们的多学科门诊。他们以男性为主，平均年龄为56.5±7.7岁。所有病例均在肝硬化基础上发生HCC，主要病因是丙型肝炎病毒（71%）。我们的大多数患者为Child-Pugh A级（50%）或B级（36.9%），常见表现为单个小病灶。经动脉化疗栓塞是最常用的治疗方法（32.4%）。6个月时总生存率为79.9%，1年时为54.5%，2年时为22.4%。血清胆红素、肿瘤部位和治疗类型是生存的重要独立预后因素。
我们的主要预后变量是胆红素水平、肝双叶受累情况以及特定治疗（根治性或姑息性）的应用。多学科门诊可加强HCC的管理。
