title: Hepatocellular carcinoma in Child-Pugh C cirrhosis: prognostic factors and survival benefit of nontransplant treatments.
abstract: A retrospective multicenter study was conducted to clarify the survival benefit of nontransplant treatments for patients with hepatocellular carcinoma (HCC) associated with Child-Pugh C cirrhosis. Data on 436 patients, including 203 treated patients with HCC, were collected from 20 institutions in Japan. Cox's proportional hazards model corrected for bias by propensity score analysis clearly showed the following as significant independent prognostic factors, including all four nontransplant treatments examined: transarterial chemoembolization, hepatic arterial infusion chemotherapy, percutaneous ethanol injection therapy, radiofrequency ablation, hepatitis B virus, number of tumors, log α-fetoprotein, encephalopathy, ascites and prothrombin time. The cumulative survival rate was significantly higher in the treated group than in the untreated group. The present findings suggest that prognosis can be improved by nontransplant treatments in patients with low Child-Pugh scores. Since this study was retrospective, the possibility of selection bias cannot be ruled out. Therefore, verification by a prospective controlled study is warranted.
authors.affiliation: Department of Gastroenterology and Hepatology, Kinki University School of Medicine, Osakasayama, Japan.
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Kudo
authors.forename: Yukio
authors.initials: Y
authors.lastname: Osaki
authors.forename: Takashi
authors.initials: T
authors.lastname: Matsunaga
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Kasugai
authors.forename: Hiroko
authors.initials: H
authors.lastname: Oka
authors.forename: Toshihito
authors.initials: T
authors.lastname: Seki
mesh_terms: D006528:Carcinoma, Hepatocellular / Q000150:complications* / Q000401:mortality / Q000473:pathology / Q000628:therapy; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008103:Liver Cirrhosis / Q000150:complications* / Q000628:therapy; D008113:Liver Neoplasms / Q000150:complications* / Q000401:mortality / Q000473:pathology / Q000628:therapy; D016031:Liver Transplantation; D009367:Neoplasm Staging; D011379:Prognosis; D015996:Survival Rate; D047368:Tumor Burden