title: Prognosis of hepatocellular carcinoma in relation to treatment: a multivariate analysis of 178 patients from a single European institution.
abstract: BACKGROUND
  Because the prognosis of patients with hepatocellular carcinoma is not fully understood, particularly regarding therapy, we have evaluated it in a series of patients with a homogeneous diagnostic and therapeutic work-up.
  
  
  METHODS
  From 1985 to 1996, 42 variables were recorded prospectively in 178 constructive patients who had a diagnosis of hepatocellular carcinoma. Treatment consisted of liver transplantation ( n = 22), partial hepatectomy (n = 11), arterial, chemoembolization ( n = 52), systemic or regional chemotherapy (n = 51), and other therapies (n = 5); 37 patients received no specific therapy. Statistical analysis was performed according to a Cox model.
  
  
  RESULTS
  There were no differences between the survival of patients receiving chemotherapy, other therapies, or no treatment (control group n = 93). survival rates a 1,3, and 5 years were 81%, 74%, and 74% for liver transplantation, 72%, 58%, and 58% for hepatectomy, 55%, 26%, and 13% for chemoembolization, and 13%, 3%, and 0% for the control group. Cirrhosis, systemic syndrome, bilobar involvement, Child's stage C disease, and treatment were independent predictors of survival.
  
  
  CONCLUSIONS
  This series shows that certain easily accessible parameters may help establish individual prognosis and stratify patients in clinical trials and indicates that chemoembolization, partial resection, and liver transplantation can prolong life expectancy of patients with hepatocellular carcinoma.
authors.affiliation: Department of Internal Medicine, University Clinic, Pamplona, Spain.
authors.forename: B
authors.initials: B
authors.lastname: Sangro
authors.forename: M
authors.initials: M
authors.lastname: Herráiz
authors.forename: M A
authors.initials: MA
authors.lastname: Martínez-González
authors.forename: I
authors.initials: I
authors.lastname: Bilbao
authors.forename: I
authors.initials: I
authors.lastname: Herrero
authors.forename: O
authors.initials: O
authors.lastname: Beloqui
authors.forename: M
authors.initials: M
authors.lastname: Betés
authors.forename: A
authors.initials: A
authors.lastname: de-la-Peña
authors.forename: J A
authors.initials: JA
authors.lastname: Cienfuegos
authors.forename: J
authors.initials: J
authors.lastname: Quiroga
authors.forename: J
authors.initials: J
authors.lastname: Prieto
mesh_terms: D006528:Carcinoma, Hepatocellular / Q000401:mortality* / Q000628:therapy*; D016461:Chemoembolization, Therapeutic; D005060:Europe / Q000453:epidemiology; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000401:mortality* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011379:Prognosis; D016019:Survival Analysis