title: Survival and prognostic factors for hepatocellular carcinoma: an Egyptian multidisciplinary clinic experience.
abstract: BACKGROUND
  Hepatocellular carcinoma (HCC) is a dismal tumor with a high incidence, prevalence and poor prognosis and survival. Management of HCC necessitates multidisciplinary clinics due to the wide heterogeneity in its presentation, different therapeutic options, variable biologic behavior and background presence of chronic liver disease. We studied the different prognostic factors that affected survival of our patients to improve future HCC management and patient survival.
  
  
  METHODS
  This study is performed in a specialized multidisciplinary clinic for HCC in Kasr El Eini Hospital, Cairo University, Egypt. We retrospectively analyzed the different patient and tumor characteristics and the primary mode of management applied to our patients. Further analysis was performed using univariate and multivariate statistics.
  
  
  RESULTS
  During the period February 2009 till February 2013, 290 HCC patients presented to our multidisciplinary clinic. They were predominantly males and the mean age was 56.5 ± 7.7 years. All cases developed HCC on top of cirrhosis that was mainly due to HCV (71%). Most of our patients were Child-Pugh A (50%) or B (36.9%) and commonly presented with small single lesions. Transarterial chemoembolization was the most common line of treatment used (32.4%). The overall survival was 79.9% at 6 months, 54.5% at 1 year and 22.4% at 2 years. Serum bilirubin, site of the tumor and type of treatment were the significant independent prognostic factors for survival.
  
  
  CONCLUSIONS
  Our main prognostic variables are the bilirubin level, the bilobar hepatic affection and the application of specific treatment (either curative or palliative). Multidisciplinary clinics enhance better HCC management.
authors.affiliation: Department Endemic Hepatogastroenterology, National Cancer Institute, Cairo University, Cairo, Egypt E-mail : hendshousha@yahoo.com.
authors.forename: Ashraf Omar
authors.initials: AO
authors.lastname: Abdelaziz
authors.forename: Tamer Mahmoud
authors.initials: TM
authors.lastname: Elbaz
authors.forename: Hend Ibrahim
authors.initials: HI
authors.lastname: Shousha
authors.forename: Mostafa Mohamed
authors.initials: MM
authors.lastname: Ibrahim
authors.forename: Mostafa Abdel
authors.initials: MA
authors.lastname: Rahman El-Shazli
authors.forename: Ahmed Hosni
authors.initials: AH
authors.lastname: Abdelmaksoud
authors.forename: Omar Abdel
authors.initials: OA
authors.lastname: Aziz
authors.forename: Hisham Atef
authors.initials: HA
authors.lastname: Zaki
authors.forename: Inas Anwar
authors.initials: IA
authors.lastname: Elattar
authors.forename: Mohamed Mahmoud
authors.initials: MM
authors.lastname: Nabeel
mesh_terms: D001663:Bilirubin / Q000097:blood; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis* / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D016461:Chemoembolization, Therapeutic / Q000379:methods*; D004534:Egypt; D005260:Female; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications; D008113:Liver Neoplasms / Q000175:diagnosis* / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012552:Schistosomiasis / Q000150:complications; D016896:Treatment Outcome
chemical_list: D001663:Bilirubin