title: [Prognostic factors and survival according to the Okuda stage in patients with hepatocellular carcinoma].
abstract: OBJECTIVE
  There are several staging systems to decide the stage of hepatocellular carcinoma (HCC), but yet incomplete. Okuda stage which includes both tumor characteristics and liver function is widely used. The aims of this study were to assess the usefulness of known prognostic factors and Okuda staging system in 237 cases of HCC.
  
  
  METHODS
  A retrospective analysis of 237 cases of HCC diagnosed from 2000 to 2002 was performed. We analyzed prognostic factors such as age, sex, liver cirrhosis, Child-Pugh classification, tumor size, albumin, bilirubin, alpha-FP, ascites, encephalopathy and Okuda stage. Prognostic analysis was performed for single variables and estimating survival distributions were analyzed by the Kaplan-Meier method, statistically compared by the log-rank test.
  
  
  RESULTS
  Patients had a mean age of 57.5 years and were predominantly men (79.7%). Liver cirrhosis were noticed in 214 cases (90.3%). The overall median survival period was 25.7 months. The median survival period was correlated to bilirubin, ascites, alpha-FP, tumor size, and Child-Pugh classification, but not to age, sex, and pattern of viral infection. The median survival period of the Okuda stage I, II and III cases was 35.8, 11.9 and 8.5 months (p<0.001).
  
  
  CONCLUSIONS
  The median survival period of patients with HCC is significantly correlated to Okuda staging system, and survival period has improved than the initial data when the Okuda staging system was published in 1985. However, in order to discriminate early staged HCC more accurately, other prognostic factors such as alpha-FP and tumor morphology should be included in future staging system for HCC.
authors.affiliation: Department of Internal Medicine, Institute of Gastroenterology, Dong-A University College of Medicine, Busan, Korea.
authors.forename: Jong Han
authors.initials: JH
authors.lastname: Kim
authors.forename: Sang Young
authors.initials: SY
authors.lastname: Han
authors.forename: Ah Young
authors.initials: AY
authors.lastname: Kang
authors.forename: You Jeong
authors.initials: YJ
authors.lastname: Shon
authors.forename: Young Hun
authors.initials: YH
authors.lastname: Koo
authors.forename: Seung Hoon
authors.initials: SH
authors.lastname: Ryu
authors.forename: Jeong Hwan
authors.initials: JH
authors.lastname: Cho
authors.forename: Seung Ho
authors.initials: SH
authors.lastname: Han
authors.forename: Sung Wook
authors.initials: SW
authors.lastname: Lee
authors.forename: Jin Seok
authors.initials: JS
authors.lastname: Jang
authors.forename: Jong Hoon
authors.initials: JH
authors.lastname: Lee
authors.forename: Myung Hwan
authors.initials: MH
authors.lastname: Roh
authors.forename: Seok Ryeol
authors.initials: SR
authors.lastname: Choi
mesh_terms: D006528:Carcinoma, Hepatocellular / Q000401:mortality* / Q000473:pathology; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000401:mortality* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D016019:Survival Analysis; D015996:Survival Rate