A multicentre, multinational study of clinical characteristics and prognosis of hepatocellular carcinoma; [Étude multicentrique et multinationale des caractéristiques cliniques et du pronostic du carcinome hépatocellulaire]
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Date
2023
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Abstract
Background: Hepatocellular carcinoma (HCC) is a significant health problem, and the associated mortality rate is increasing. Aim: We aimed to determine the clinical characteristics and prognosis for HCC in member countries of the OncoBridge Study Group. Methods: We recruited 630 patients diagnosed with HCC between 2013 and 2019 from 4 countries (Türkiye, Russia, Georgia, and Greece). Univariate and multivariate analyses were conducted to investigate clinical and laboratory prognostic factors. Receiver operating characteristic (ROC) analysis was used to determine the prognostic value of the neutrophil to lymphocyte ratio (NLR) and alpha-fetoprotein (AFP) value. Results: The 3 most common etiological factors were hepatitis B infection (39.7%), hepatitis C virus infection (17.0%) and non-alcoholic fatty liver disease (9.0%). Median overall survival for the whole group was 25 [95% confidence interval (CI): 15.7–34.2] months. Cut-off values for AFP and NLR were accepted as 200 ng/mL and 3.45, respectively. The area under the ROC curve values for AFP, NLR and NLR+AFP were 0.625 (95% CI: 0.547–0.704), 0.589 (95% CI: 0.512–0.667) and 0.657 (95% CI: 0.583–0.731). From the multivariate analysis, advanced tumour size, lymph node involvement and metastasis (TNM) stage, presence of cirrhosis, high AFP, and high NLR values were associated with poor survival. Conclusion: AFP, NLR, advanced TNM, and presence of cirrhosis may predict prognosis in patients with HCC. Studies involving more countries are needed to corroborate these findings. © Authors 2023; Licensee: World Health Organization.
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alpha-Fetoproteins , Carcinoma, Hepatocellular , Humans , Liver Neoplasms , Lymphocytes , Prognosis , Retrospective Studies , ROC Curve , acetylsalicylic acid , alpha fetoprotein , hydroxymethylglutaryl coenzyme A reductase inhibitor , sorafenib , sulfonylurea , alpha fetoprotein , ablation therapy , adult , alcohol consumption , Article , cancer prognosis , cancer staging , Child Pugh score , coding , controlled study , diabetes mellitus , diagnostic test accuracy study , female , Georgia (republic) , Greece , hepatitis B , hepatitis C , human , liver cell carcinoma , liver cirrhosis , lymphocyte count , major clinical study , male , mortality rate , multicenter study , neutrophil count , neutrophil lymphocyte ratio , nonalcoholic fatty liver , overall survival , predictive value , progression free survival , receiver operating characteristic , retrospective study , Russian Federation , sensitivity and specificity , smoking , tumor volume , Turkey (republic) , virus hepatitis , clinical trial , liver cell carcinoma , liver tumor , lymphocyte , pathology , prognosis