Published online Jun 21, 2013. doi: 10.3748/wjg.v19.i23.3649
Revised: March 25, 2013
Accepted: April 9, 2013
Published online: June 21, 2013
AIM: To analyze the prognostic factors of 5-year survival and 10-year survival in hepatocellular carcinoma (HCC) patients, and to explore the reasons for long-term survival and provide choice of treatment modalities for HCC patients.
METHODS: From January 1990 to October 2012, 8450 HCC patients were included in a prospective database compiled by the Information Center after hospital admission. Long-term surviving patients were included in a 10-year survival group (520 patients) and a 5-year survival group (1516 patients) for analysis.The long-term survival of HCC patients was defined as the survival of 5 years or longer. Clinical and biologic variables were assessed using univariate and multivariate analyses. The survival of patients was evaluated by follow-up data.
RESULTS: The long-term survival of HCC patients was associated with the number of lesions, liver cirrhosis and Child-Pugh classification. It was not found to be associated with tumor diameter, histological stage, and pretreatment level of serum α-fetoprotein. The differences in clinical factors between the 5-year survival and the 10-year survival were found to be the number of lesions, liver cirrhosis, Child-Pugh classification, and time elapsed until first recurrence or metastasis. The survival period of different treatment modalities in the patients who survived for 5 years and 10 years showed significant differences: (in order of significance) surgery alone > surgery-transcatheter arterial chemoembolization (TACE) > TACE-radiofrequency ablation (RFA) > TACE alone > surgery-TACE-RFA. The 10-year survival of HCC patients was not associated with the choice of treatment modality.
CONCLUSION: This retrospective study elucidated survival outcomes, prognostic factors affecting survival and treatment modalities in HCC patients.
Core tip: This manuscript was a retrospective analysis and it revealed that the long-term survival of hepatocellular carcinoma (HCC) patients was associated with the number of lesions, liver cirrhosis and Child-Pugh classification, whiletumor diameter, histological stage, and pretreatment level of serum α-fetoprotein were not related. Conditions for long-term survival of HCC patients were: age over 50 years, no cirrhosis, a uninodular lesion, no vessel invasion, tumor-node-metastasis stage I or II, Child-Pugh classification Class A, and appropriate treatment. The best treatment modality for more than 10 years survival compared with 5 years survival were surgery alone > surgery-transcatheter arterial chemoembolization (TACE) > TACE-radiofrequency ablation (RFA) > TACE alone > surgery-TACE-RFA.