[Prognostic factors and survival according to the Okuda stage in patients with hepatocellular carcinoma].
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.
Kim
Jong Han
JH
Department of Internal Medicine, Institute of Gastroenterology, Dong-A University College of Medicine, Busan, Korea.
Han
Sang Young
SY
Kang
Ah Young
AY
Shon
You Jeong
YJ
Koo
Young Hun
YH
Ryu
Seung Hoon
SH
Cho
Jeong Hwan
JH
Han
Seung Ho
SH
Lee
Sung Wook
SW
Jang
Jin Seok
JS
Lee
Jong Hoon
JH
Roh
Myung Hwan
MH
Choi
Seok Ryeol
SR
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