Survival and Prognostic Factors for Hepatocellular Carcinoma: an Egyptian Multidisciplinary Clinic Experience

Background: Hepatocellular carcinoma (HCC) is a dismal tumor with a high incidence, prevalence and poorprognosis and survival. Management of HCC necessitates multidisciplinary clinics due to the wide heterogeneityin its presentation, different therapeutic options, variable biologic behavior and background presence of chronicliver disease. We studied the different prognostic factors that affected survival of our patients to improve futureHCC management and patient survival. Materials and
Methods: This study is performed in a specializedmultidisciplinary clinic for HCC in Kasr El Eini Hospital, Cairo University, Egypt. We retrospectively analyzedthe different patient and tumor characteristics and the primary mode of management applied to our patients.Further analysis was performed using univariate and multivariate statistics.
Results: During the period February2009 till February 2013, 290 HCC patients presented to our multidisciplinary clinic. They were predominantlymales and the mean age was 56.5±7.7years. All cases developed HCC on top of cirrhosis that was mainly dueto HCV (71%). Most of our patients were Child-Pugh A (50%) or B (36.9%) and commonly presented withsmall 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 thetumor and type of treatment were the significant independent prognostic factors for survival.
Conclusions: Ourmain prognostic variables are the bilirubin level, the bilobar hepatic affection and the application of specifictreatment (either curative or palliative). Multidisciplinary clinics enhance better HCC management.