ASPO Abstracts
Clinical factors affect long-term survival of advanced hepatocellular carcinoma patients
Category: Survivorship & Health Outcomes/Comparative Effectiveness Research, Survivorship & Health Outcomes/Comparative Effectiveness Research
Conference Year: 2018
Abstract Body:
Background/Purpose: Most hepatocellular carcinoma (HCC) patients are diagnosed at late stages, and the 5-year relative survival rate for patients with advanced HCC is only 3%. A recent study using the Surveillance, Epidemiology, and End Results (SEER) data found that a small proportion (10%) of patients diagnosed with advanced HCC survived longer than 12 months. Notably, longer survival was correlated with age, female sex, year of diagnosis, tumor grade, and surgery status. The aim of the present study is to explore additional factors associated with longer survival in advanced HCC, such as smoking history and presence of liver disease. Methods: To analyze additional characteristics not examined in the SEER data, we identified 249 individuals with Stage IVA and IVB HCC from patients who participated in a University of Texas MD Anderson Cancer Center clinical-epidemiological study from 2000-2014. We used the median overall survival of patients who received systemic therapy (5.8 months) to stratify patients into two groups: long-term survivors (survival > 5.8 months) and short-term survivors (survival ‰¤ 5.8 months). Using data from personal interviews and medical records, we compared the two groups by clinical, demographic, and other factors. Variables that differed significantly between the two groups were included in a multivariate Cox proportional hazards model used to identify independent predictors of prolonged survival among patients diagnosed with late-stage HCC. Results: Clinical features of long-term survivors differed significantly from those of short-term survivors while demographic and other factors, such as age and hepatitis virus status, did not differ between the two groups. Cox model analysis indicated that clinical factors, such as absence of cirrhosis and better Child-Pugh scores, were independent predictors of prolonged survival. Conclusions: Clinical characteristics of HCC patients diagnosed with advanced disease predicts prolonged survival. Therefore, better management of liver disease may help improve survival from HCC, and understanding the mechanism of this benefit is worthy of further inquiry.
Keywords: Advanced hepatocellular carcinoma Long-term Survival