TY - JOUR
T1 - Identification of clinical phenotypes and related survival in patients with large hccs
AU - Carr, Brian I.
AU - Guerra, Vito
AU - Donghia, Rossella
AU - Farinati, Fabio
AU - Giannini, Edoardo G.
AU - Muratori, Luca
AU - Rapaccini, Gian Ludovico
AU - Di Marco, Maria
AU - Caturelli, Eugenio
AU - Zoli, Marco
AU - Sacco, Rodolfo
AU - Celsa, Ciro
AU - Campani, Claudia
AU - Mega, Andrea
AU - Guarino, Maria
AU - Gasbarrini, Antonio
AU - Svegliati-Baroni, Gianluca
AU - Foschi, Francesco Giuseppe
AU - Biasini, Elisabetta
AU - Masotto, Alberto
AU - Nardone, Gerardo
AU - Raimondo, Giovanni
AU - Azzaroli, Francesco
AU - Vidili, Gianpaolo
AU - Brunetto, Maurizia Rossana
AU - Trevisani, Franco
N1 - Funding Information:
Funding: This work was supported in part by NIH grant CA 82723 (B.I.C).
Publisher Copyright:
© 2021 by the authors. Licensee MDPI, Basel, Switzerland.
Copyright:
Copyright 2021 Elsevier B.V., All rights reserved.
PY - 2021/2/2
Y1 - 2021/2/2
N2 - Background. Hepatocellular carcinoma (HCC) factors, especially maximum tumor diameter (MTD), tumor multifocality, portal vein thrombosis (PVT), and serum alpha-fetoprotein (AFP), influence survival. Aim. To examine patterns of tumor factors in large HCC patients. Methods. A database of large HCC patients was examined. Results. A multiple Cox proportional hazard model on death identified low serum albumin levels and the presence of PVT and multifocality, with each having a hazard ratio ≥2.0. All combinations of these three parameters were examined in relation to survival. Using univariate Cox analysis, the combination of albumin >3.5 g/dL and the absence of both PVT and multifocality had the best survival rate, while all combinations that included the presence of PVT had poor survival and hazard ratios. We identified four clinical phenotypes, each with a distinct median survival: patients with or without PVT or multifocality plus serum albumin ≥3.5 (g/dL), with each subgroup displaying high (≥100 IU/mL) or low (<100 IU/mL) blood AFP levels. Across a range of MTDs, we identified only two significant trends, blood AFP and platelets. Conclusions. Patients with large HCCs have distinct phenotypes and survival, as identified by the combination of PVT, multifocality, and blood albumin levels.
AB - Background. Hepatocellular carcinoma (HCC) factors, especially maximum tumor diameter (MTD), tumor multifocality, portal vein thrombosis (PVT), and serum alpha-fetoprotein (AFP), influence survival. Aim. To examine patterns of tumor factors in large HCC patients. Methods. A database of large HCC patients was examined. Results. A multiple Cox proportional hazard model on death identified low serum albumin levels and the presence of PVT and multifocality, with each having a hazard ratio ≥2.0. All combinations of these three parameters were examined in relation to survival. Using univariate Cox analysis, the combination of albumin >3.5 g/dL and the absence of both PVT and multifocality had the best survival rate, while all combinations that included the presence of PVT had poor survival and hazard ratios. We identified four clinical phenotypes, each with a distinct median survival: patients with or without PVT or multifocality plus serum albumin ≥3.5 (g/dL), with each subgroup displaying high (≥100 IU/mL) or low (<100 IU/mL) blood AFP levels. Across a range of MTDs, we identified only two significant trends, blood AFP and platelets. Conclusions. Patients with large HCCs have distinct phenotypes and survival, as identified by the combination of PVT, multifocality, and blood albumin levels.
KW - Albumin
KW - HCC
KW - Large
KW - Multifocality
KW - Phenotypes
KW - PVT
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U2 - 10.3390/cancers13040592
DO - 10.3390/cancers13040592
M3 - Article
AN - SCOPUS:85100256597
VL - 13
SP - 592
JO - Cancers
JF - Cancers
SN - 2072-6694
IS - 4
ER -