title: Untreated hepatocellular carcinoma in Egypt: outcome and prognostic factors.
abstract: BACKGROUND
  Hepatocellular carcinoma (HCC) is a common cancer worldwide as well as in Egypt with hepatitis C and B, alcohol and aflatoxins being the commonest risk factors.
  
  
  OBJECTIVE
  The objective of this study was to assess the prognostic factors affecting overall survival (OS) of untreated HCC in Egypt.
  
  
  METHODS
  This retrospective study was conducted at Tanta Cancer Center, Egypt where 288 HCC cases who received no specific therapy and were followed-up until death were identified. The impact of possible prognostic factors on OS was assessed using the log-rank test (univariate analyses) and Cox regression method (multivariate analysis).
  
  
  RESULTS
  The median OS of untreated HCC was 2.3 months (95% confidence interval: 1.9-2.6). The 1, 3, 6, 12, 24 months OS rates were 84%, 42%, 21%, 9%, and 3%, respectively. All cases had died by 46 months. Male sex, advanced Child-Pugh class, the clinical presentation of ascites, cough, fatigue, and the presence of metastases were associated with poor survival (P<0.05 for all). In multivariate analysis; cough, presence of ascites, and Child-Pugh class were independent predictors of poor survival.
  
  
  CONCLUSIONS
  OS in untreated HCC in Egypt is very short. Many factors interact to produce this dismal survival.
authors: Medical Oncology/Hematology, National Cancer Institute, Cairo University, Cairo, Egypt.
authors: Ahmed Abdelmabood
authors: AA
authors: Zeeneldin
authors: Medical Oncology/Hematology, National Cancer Institute, Cairo University, Cairo, Egypt.
authors: Salem Eid
authors: SE
authors: Salem
authors: Medical Oncology/Hematology, National Cancer Institute, Cairo University, Cairo, Egypt.
authors: Amira Diaa
authors: AD
authors: Darwish
authors: Medical Oncology/Hematology, National Cancer Institute, Cairo University, Cairo, Egypt.
authors: Mosaad Mahmoud
authors: MM
authors: El-Gammal
authors: Medical Oncology/Hematology, National Cancer Institute, Cairo University, Cairo, Egypt.
authors: Marwa Mahmoud
authors: MM
authors: Hussein
authors: Medical Oncology, Tanta Cancer Center, Tanta, Egypt.
authors: Mohamed
authors: M
authors: Saadeldin
keywords: Egypt; hepatocellular carcinoma; prognosis; survival