title: [Prognostic factors in patients with non-active treatment of hepatocellular carcinoma].
abstract: OBJECTIVE
  To evaluate factors associated with poor survival in patients with non-active treatment of hepatocellular carcinoma (HCC).
  
  
  METHODS
  Between May 2003 and June 2005, 50 patients with HCC were deemed unsuitable for active treatment, following the Barcelona Clinic Liver Cancer staging system. Symptomatic treatment was provided. Kaplan-Meier curves were constructed and compared by the log-rank test to identify factors associated with poor survival. Independent factors predictive of survival were evaluated by multivariate Cox regression analysis.
  
  
  RESULTS
  The mean age was 65.6 +/- 11.9 years and 84% of the patients were men. Forty-eight percent of the patients had hepatitis C infection and 58% were Child-Pugh grade A. HCC was multinodular in 54% and the total tumor size was more than 5 cm in 90% of patients. Thirty-four percent of the patients had malignant portal thrombosis and four patients had metastases. Thirty-eight percent of the patients had received previous treatment. The median follow-up was 9.2 months and 1- and 2-year survival was 46% and 17.5%, respectively. Poor survival was associated with male sex, alpha-fetoprotein values of > 400 ng/ml, albumin levels of < 3 g/dl, and metastases. Independent predictors identified by multivariate Cox regression analysis were male sex, albumin levels of < 3 g/dl, and alpha-fetoprotein values of > 400 ng/ml. The median survival in patients with two or more independent factors was significantly lower than that in patients with none or only one factor (14.2 vs. 4.1 months).
  
  
  CONCLUSIONS
  Survival in patients with non-active treatment of hepatocellular carcinoma can be estimated and the factors involved allow separate groups of patients with different short- to medium-term prognoses to be identified.
authors.affiliation: Servicio de Aparato Digestivo, Hospital General Universitario Gregorio Marañón, Madrid, España.
authors.forename: Antonio
authors.initials: A
authors.lastname: Díaz Sánchez
authors.forename: Oscar
authors.initials: O
authors.lastname: Núñez Martínez
authors.forename: Marisa
authors.initials: M
authors.lastname: Prieto Martín
authors.forename: Inmaculada
authors.initials: I
authors.lastname: Beceiro Pedreño
authors.forename: Javier
authors.initials: J
authors.lastname: Calleja Kempin
authors.forename: Leandro
authors.initials: L
authors.lastname: Santos Castro
authors.forename: Avertano
authors.initials: A
authors.lastname: Muro de la Fuente
authors.forename: Gerardo
authors.initials: G
authors.lastname: Clemente Ricote
authors.forename: Ana
authors.initials: A
authors.lastname: Matilla Peña
mesh_terms: D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000401:mortality* / Q000473:pathology; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000401:mortality* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012307:Risk Factors; D016019:Survival Analysis