title: Predictors of Survival in Hepatocellular Carcinoma Patients.
abstract: BACKGROUND
  Hepatocellular carcinoma (HCC) is the fifth most common tumor worldwide, with an incidence equal to the death rate.
  
  
  METHODS
  We aimed to detect the prognostic factors for HCC patients. We retrospectively analyzed 12 years data of 115 patients who have biopsy-proven HCC. Clinical and demographic characteristics of patients with treatment modalities, survival rates, and prognostic factors were analyzed.
  
  
  RESULTS
  There were 93 male patients, and the mean age was 63.5±11.8 years. Most patients had cirrhosis due to hepatitis virus infection. Median follow-up time was 17 months (1 month-9.5 years) after the diagnosis of HCC. The nodule was single in 43 (37.4%) patients, there were 2-3 nodules in 30 (26.1%), and >3 or diffuse nodules in 42 (36.5%) patients. Distribution of treatment modalities was as follows: 23 (20%) patients had liver transplantation, 15 (13%) had HCC resection, 12 patients (10.4%) had radiofrequency ablation (RFA), 26 patients (22.6%) had transarterial chemoembolization (TACE), 2 (1.7%) had alcohol ablation, and 37 patients (32.2%) had no treatment. Tumor sizes of 9 patients (39.1%) in the transplanted group exceeded the Milan criteria. Mean survival was 72±6.9, 78.8 ±12.5, 19.5±2.8, 20.6±4.2, 16.0±5.9 months in those that received transplantation, resection, RFA, TACE, and no treatment, respectively (p<0.001). Survival was significantly poorer in patients >63 years old (p=0.001), with serum albumin level ≤3.4 g/dL (p=0.01), and with diffuse HCC (p<0.001).
  
  
  CONCLUSIONS
  Survival was significantly better in patients who underwent liver transplantation or surgical resection. Tumor number, age, and serum albumin level were the most important prognostic factors related to overall survival.
authors.affiliation: Department of Gastroenterology, Ankara Yüksek Ihtisas Research and Training Hospital, Ankara, Turkey.
authors.forename: Hale
authors.initials: H
authors.lastname: Gokcan
authors.affiliation: Department of Gastroenterology, Baskent University Faculty of Medicine, İstanbul, Turkey.
authors.forename: Nurten
authors.initials: N
authors.lastname: Savaş
authors.affiliation: Department of Biostatistics, Ankara University Faculty of Medicine, Ankara, Turkey.
authors.forename: Derya
authors.initials: D
authors.lastname: Oztuna
authors.affiliation: Department of Transplantation and General Surgery, Baskent University Faculty of Medicine, Ankara, Turkey.
authors.forename: Gokhan
authors.initials: G
authors.lastname: Moray
authors.affiliation: Department of Radiology, Baskent University Faculty of Medicine, Ankara, Turkey.
authors.forename: Fatih
authors.initials: F
authors.lastname: Boyvat
authors.affiliation: Department of Transplantation and General Surgery, Baskent University Faculty of Medicine, Ankara, Turkey.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Haberal
mesh_terms: D000368:Aged; D001707:Biopsy, Needle; D006528:Carcinoma, Hepatocellular / Q000401:mortality* / Q000473:pathology / Q000628:therapy*; D017115:Catheter Ablation / Q000379:methods / Q000401:mortality; D002423:Cause of Death; D016461:Chemoembolization, Therapeutic / Q000379:methods / Q000401:mortality; D015331:Cohort Studies; D016208:Databases, Factual; D018572:Disease-Free Survival; D005260:Female; D006498:Hepatectomy / Q000379:methods / Q000401:mortality; D006801:Humans; D007150:Immunohistochemistry; D053208:Kaplan-Meier Estimate; D008113:Liver Neoplasms / Q000401:mortality* / Q000473:pathology / Q000628:therapy*; D016031:Liver Transplantation / Q000379:methods / Q000401:mortality; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D018570:Risk Assessment; D015996:Survival Rate; D014421:Turkey