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Analysis of 6381 hepatocellular carcinoma patients in southern Taiwan: prognostic features, treatment outcome, and survival.

Abstract：

BACKGROUND:This hospital-based analysis was conducted to identify prognostic factors of hepatocellular carcinoma (HCC) in a hepatitis B virus endemic area. METHODS:A total of 6381 HCC cases, diagnosed from 1986 to 2002, were enrolled, and 2890 (42.3%) of them were not treated. Survival rates were analyzed by correlation with the national mortality databank. Missing data and correlations among prognostic factors were considered in the analysis. RESULTS:The overall 1-year, 3-year, 5-year, and 7-year survival rates were 44.3%, 24.9%, 17.1%, and 13%, respectively. Multivariate analysis revealed that the independent factors influencing survival were the initial treatment modality, degree of liver function impairment, hepatitis B surface antigen positivity, tumor status, and alpha-fetoprotein. Besides these well-known prognostic factors, high alanine aminotransferase (ALT) levels and a high aspartate aminotransferase (AST)/ALT ratio were identified as independent poor prognostic factors. CONCLUSIONS:This study, which considered untreated cases, missing data, and correlations between variables and official survival data sets, provides a large-scale comprehensive survival analysis. According to our results, high ALT and high AST/ALT were independent poor prognostic factors. Therefore, viral activity should be controlled in HCC patients, and patients with elevated AST/ALT ratios should be carefully monitored.

journal_name

J Gastroenterol

journal_title

Journal of gastroenterology

authors

Changchien CS,Chen CL,Yen YH,Wang JH,Hu TH,Lee CM,Wang CC,Cheng YF,Huang YJ,Lin CY,Lu SN

doi

10.1007/s00535-007-2134-9

subject

Has Abstract

pub_date

2008-01-01 00:00:00

pages

159-70

issue

2

eissn

0944-1174

issn

1435-5922

journal_volume

43

pub_type

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