Impact of alcohol consumption on treatment outcome of hepatocellular carcinoma patients with viral hepatitis who underwent transarterial chemoembolization

Table 1 Baseline demographic data of patients with viral hepatitis only (group A) and those with viral hepatitis concurrent with alcohol consumption (group B)

Variables	Group A (n = 53), %	Group (n = 16), %	P value
Female sex	18 (34.0)	0 (0)	0.007
Age (yr): mean ± SD	56.1 ± 10.5	53.6 ± 7.5	0.365
Body mass index (kg/m2): mean ± SD	23.2 ± 4.3	22.0 ± 3.1	0.298
Underlying disease
Diabetic mellitus	10 (18.9)	2 (12.5)	0.718
Hypertension	9 (17.0)	2 (12.5)	1.000
Dyslipidemia	2 (3.8)	0 (0)	1.000
Hepatitis B virus infection	34 (64.2)	6 (37.5)	0.058
Hepatitis C virus infection	20 (37.7)	10 (62.5)	0.080
Hepatitis B and C virus coinfection	1 (1.9)	0 (0)	1.000
Cirrhosis	53 (100)	16 (100)	N/A
Child–Turcotte–Pugh classification			0.109
A	35 (66.0)	7 (43.8)
B	18 (34.0)	9 (56.2)
Presence of portal hypertension	36 (67.9)	10 (62.5)	0.687
Laboratory data
Hemoglobin (g/dL): mean ± SD	12.3 ± 1.9	12.2 ± 1.9	0.883
Platelet median (×103/mL): Median (IQR)	119 (78 to 208)	116 (64 to 175)	0.803
Serum creatinine (mg/dL): Median (IQR)	0.9 (0.7 to 1.0)	0.8 (0.7 to 0.9)	0.257
Serum Albumin (g/dL): mean ± SD	3.6 ± 0.7	3.2 ± 0.4	0.017
Total bilirubin (mg/dL): Median (IQR)	1.0 (0.6 to 2.0)	1.7 (0.9 to 2.1)	0.155
Aspartate aminotransferase (mg/dL), median (IQR)	63.0 (42.0 to 116.0)	96.5(73.5 to 155.0)	0.013
Alanine aminotransferase (mg/dL), median (IQR)	41.0 (23.0 to 76.0)	52.5 (45.0 to 85.0)	0.151
International normalized ratio: mean ± SD	1.2 ± 0.2	1.2 ± 0.4	0.654
Hepatitis B viral load (IU/mL): Median (IQR)	1450 (Undetectable to 165000)	32650 (13700 to 966000)	0.706
Alpha-fetoprotein (ng/mL): Median (IQR)	20.5 (9.3 to 499.8)	176.45 (13.3 to 992.2)	0.207
MELD: mean ± SD	9 (7 to 12)	11 (8 to 12)	0.307
ECOG score			1.000
0	42 (79.2)	13 (81.2)
1	11 (20.8)	3 (18.8)

SD: Standard deviation; IQR: Interquartile range; IU: International unit; MELD: Model for end-stage liver disease; ECOG: Eastern Cooperative Oncology Group; N/A: Not applicable.

Table 2 Comparison of tumor characteristics and response between patients with viral hepatitis only (group A) and those with viral hepatitis concurrent with alcohol consumption (group B)

Variables	Group A (n = 53), %	Group (n = 16), %	P value
Multinodular (> 1 lesion)	44 (83.0)	14 (87.5)	1.000
Largest tumor size (cm): Median (IQR)	5.3 (3.7 to 9.0)	4.3 (2.6 to 9.0)	0.399
Largest tumor sized > 5 cm	27 (50.9)	9 (56.2)	0.710
Number of TACE sessions: median (IQR)	2 (1 to 3)	2 (1 to 3)	0.301
Achieved complete respond	13 (24.5)	0 (0)	0.030

IQR: Interquartile range; TACE: Transarterial chemoembolization.

Table 3 Univariate and multivariate Cox proportional-hazards model of predictive factors of overall survival after transarterial chemoembolization in individuals with chronic viral hepatitis

Factor	Univariate analysis			Multivariate analysis
	OR	95%CI	P value	HR	95%CI	P value
Female sex	0.722	0.384-1.358	0.312	1.103	0.516-2.359	0.800
Age, every 1-year increase	0.977	0.947-1.008	0.148	1.000	0.968-1.034	0.979
Body mass index < 18.5	0.937	0.439-2.002	0.867
Hepatitis B infection	0.841	0.487-1.453	0.535
Hepatitis C infection	1.270	0.737-2.191	0.389
Alcohol consumption	2.185	1.172-4.074	0.014	2.377	1.109-5.095	0.026
Serum albumin > 3.5 g/dL	0.717	0.414-1.240	0.234
Alpha-fetoprotein > 100 ng/mL	2.174	1.249-3.783	0.006	2.536	1.377-4.670	0.003
Child–Turcotte–Pugh classification			0.115			0.793
A	1	(reference)		1	(reference)
B	1.558	0.898-2.704		1.114	0.498-2.492
MELD score > 10	1.133	0.652-1.968	0.657
Presence of portal hypertension	1.743	0.952-3.191	0.072	2.578	1.320-5.037	0.006
ECOG			0.270
0	1	(reference)
1	1.436	0.755-2.731
Multinodular (> 1 lesion)	1.141	0.512-2.543	0.747
Largest tumor sized > 5 cm	2.203	1.242-3.906	0.007	3.558	1.824-6.939	< 0.001

MELD: Model for End-Stage Liver Disease; ECOG: Eastern Cooperative Oncology Group.