Identification of Clinical Phenotypes and Related Survival in Patients with Large HCCs

Basit Öğe Kaydı
dc.authoridguarino, maria/0000-0002-0460-4122
dc.authoridCampani, Claudia/0000-0003-3842-782X
dc.authoridGiannini, Edoardo Giovanni/0000-0001-8526-837X
dc.authoridBrunetto, Maurizia/0000-0001-8364-9152
dc.authoridVIDILI, GIANPAOLO/0000-0002-8903-5829
dc.authoridFarinati, Fabio/0000-0002-2944-1374
dc.authoridDonghia, Rossella/0000-0002-9140-673X
dc.authorwosidguarino, maria/AAM-6001-2020
dc.authorwosidSacco, Rodolfo/K-7706-2016
dc.authorwosidCampani, Claudia/AAC-4021-2022
dc.authorwosidGiannini, Edoardo Giovanni/E-1120-2012
dc.authorwosidBrunetto, Maurizia/AAU-2906-2020
dc.authorwosidVIDILI, GIANPAOLO/JWP-7510-2024
dc.authorwosidMega, Andrea/GLS-8971-2022
dc.contributor.authorCarr, Brian I.
dc.contributor.authorGuerra, Vito
dc.contributor.authorDonghia, Rossella
dc.contributor.authorFarinati, Fabio
dc.contributor.authorGiannini, Edoardo G.
dc.contributor.authorMuratori, Luca
dc.contributor.authorRapaccini, Gian Ludovico
dc.date.accessioned2024-08-04T20:49:16Z
dc.date.available2024-08-04T20:49:16Z
dc.date.issued2021
dc.departmentİnönü Üniversitesien_US
dc.description.abstractSimple Summary Factors influencing the survival of hepatocellular carcinoma (HCC) patients include portal vein thrombosis (PVT), tumor numbers (multifocality), blood alpha-fetoprotein (AFP) levels, and the degree of liver damage (levels of blood bilirubin and albumin). However, the role of tumor size can be ambiguous. We therefore examined multiple clinical characteristics for their relationship with patient death and combined the three parameters with the greatest impact to create a tool to examine the characteristics and survival of patients with normal and abnormal levels of this three-parameter tool. In patients with large tumors, we found that normal levels of these three parameters-no PVT or multifocality plus normal blood albumin levels-were associated with longer survival than any group containing patients with PVT. This good-survival group could also be divided into two subgroups, differing in survival, based on blood AFP levels. This three-parameter tool might be prognostically useful in stratifying patients and management decisions. Background. Hepatocellular carcinoma (HCC) factors, especially maximum tumor diameter (MTD), tumor multifocality, portal vein thrombosis (PVT), and serum alpha-fetoprotein (AFP), influence survival. Aim. To examine patterns of tumor factors in large HCC patients. Methods. A database of large HCC patients was examined. Results. A multiple Cox proportional hazard model on death identified low serum albumin levels and the presence of PVT and multifocality, with each having a hazard ratio >= 2.0. All combinations of these three parameters were examined in relation to survival. Using univariate Cox analysis, the combination of albumin >3.5 g/dL and the absence of both PVT and multifocality had the best survival rate, while all combinations that included the presence of PVT had poor survival and hazard ratios. We identified four clinical phenotypes, each with a distinct median survival: patients with or without PVT or multifocality plus serum albumin >= 3.5 (g/dL), with each subgroup displaying high (>= 100 IU/mL) or low (<100 IU/mL) blood AFP levels. Across a range of MTDs, we identified only two significant trends, blood AFP and platelets. Conclusions. Patients with large HCCs have distinct phenotypes and survival, as identified by the combination of PVT, multifocality, and blood albumin levels.en_US
dc.description.sponsorshipNIH [CA 82723]en_US
dc.description.sponsorshipThis work was supported in part by NIH grant CA 82723 (B.I.C).en_US
dc.identifier.doi10.3390/cancers13040592
dc.identifier.issn2072-6694
dc.identifier.issue4en_US
dc.identifier.pmid33546234en_US
dc.identifier.scopus2-s2.0-85100256597en_US
dc.identifier.scopusqualityQ1en_US
dc.identifier.urihttps://doi.org/10.3390/cancers13040592
dc.identifier.urihttps://hdl.handle.net/11616/99746
dc.identifier.volume13en_US
dc.identifier.wosWOS:000623344700001en_US
dc.identifier.wosqualityQ1en_US
dc.indekslendigikaynakWeb of Scienceen_US
dc.indekslendigikaynakScopusen_US
dc.indekslendigikaynakPubMeden_US
dc.language.isoenen_US
dc.publisherMdpien_US
dc.relation.ispartofCancersen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/openAccessen_US
dc.subjectHCCen_US
dc.subjectlargeen_US
dc.subjectphenotypesen_US
dc.subjectPVTen_US
dc.subjectmultifocalityen_US
dc.subjectalbuminen_US
dc.titleIdentification of Clinical Phenotypes and Related Survival in Patients with Large HCCsen_US
dc.typeArticleen_US

Dosyalar

Koleksiyon

WoS İndeksli Yayınlar Koleksiyonu
PubMed İndeksli Yayın Koleksiyonu
Scopus İndeksli Yayınlar Koleksiyonu