Practical Considerations of Real Life of Hepatocellular Carcinoma in a Tertiary Center of Brazil
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2017
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Background. Hepatocellular carcinoma (HCC) is the most common maligancy that develops in cirrhotic livers. Its clinical and epidemiological characteristics and morality rates vary according to geographical region. The objective of this study was to evaluate the clinical profile. epidemiological characteristics, laboratory parameters, treatment and survival of patients with HCC. Material and methods. Patients with HCC seen between 2000 and 2012 were studied. The Kapalan-Meier method was used for survival analysis according to variable in question. Results. The study included 247 patients with a mean a age of 60 +/- 10 years. There was a pre-dominance of males (74%). The main etiologies of HCC were HCV infection (55%), excessive alcohol consumption (12%), and HBV infection (8%). Liver cirrhosis was present in 92% of cases. The mean tumor number and diameter were 2 and 5 cm, respectively. Patients meeting the Milan criteria corresponded to 43% of the sample. Liver transplantation was performed in 22.4% of patients of the Milan subset and in 10% of the whole sample. The overall mean survival was 60 months,with a 1-, 3- and 5-year survival probability of 74%, 40% and 29%, respectively. Lower survival was observed among patients with alcoholic etiology. Survival was higher among patients submited to liver transplantation (P < 0.001), TACE (P < 0.001), or any kind of treatment (P < 0.001), However, no difference was found for surgical resection (P = 0.1) or sorafenib (P = 0.1). Conclusion. Patients with HCC were mainly older men diagnosed at an advanced stage. Treatment was associated with better overall survival, but few patients survived to be treated.
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Annals Of Hepatology. Mexico, v. 16, n. 2, p. 255-262, 2017.