Prognostic role and significance of paraneoplastic syndromes in hepatocellular carcinoma.
Patients with hepatocellular carcinoma (HCC) may develop paraneoplastic syndromes in the clinical course. These syndromes include hypercholesterolemia, hypoglycemia, hypercalcemia, and erythrocytosis, among others. This study was designed to assess the role of prognostic influence of paraneoplastic syndromes in patients with HCC. In a cohort of 175 patients with HCC patients, we compared the clinical features of patients with HCC with or without paraneoplastic syndromes. In addition, survival rates of patients with individual paraneoplastic syndromes and those without were also evaluated. Moreover, factors independently predicting prognosis among patients with HCC with or without paraneoplastic syndromes were analyzed. Among 175 patients with HCC, 54 patients presented paraneoplastic syndromes, and the prevalence was 30.9 per cent. There was no difference of clinical characteristics between patients with HCC with and without paraneoplastic syndromes on diagnosis. However, the patients with paraneoplastic syndromes had a significantly less survival rate comparing with those without during a 5-year follow-up. Cox regression analysis demonstrated that high Child-Pugh grade, large tumor size, portal vein tumor thrombosis, and distant metastasis were all independent unfavorable prognostic factors for survival of patients with HCC. Paraneoplastic syndromes as independent risk factors play a significant role in the progress of HCC and lead to poor prognosis in patients with HCC.
Department of General Surgery, Peking Union Medical College Hospital, Beijing, China.
Qiang
Q
Qu
Shaobin
S
Wang
Shuguang
S
Chen
Li
L
Zhou
Jing-An
JA
Rui
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000401:mortality* / Q000473:pathology / Q000601:surgery*; D002423:Cause of Death; D002648:Child; D015331:Cohort Studies; D005260:Female; D006801:Humans; D006934:Hypercalcemia / Q000175:diagnosis / Q000401:mortality; D007003:Hypoglycemia / Q000175:diagnosis / Q000401:mortality; D053208:Kaplan-Meier Estimate; D008113:Liver Neoplasms / Q000401:mortality* / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010257:Paraneoplastic Syndromes / Q000175:diagnosis* / Q000453:epidemiology*; D016012:Poisson Distribution; D015995:Prevalence; D011379:Prognosis; D016016:Proportional Hazards Models; D012016:Reference Values; D012189:Retrospective Studies; D018570:Risk Assessment; D012737:Sex Factors; D016019:Survival Analysis; D016896:Treatment Outcome; D020246:Venous Thrombosis / Q000175:diagnosis / Q000401:mortality; D055815:Young Adult