Natural history of untreatable hepatocellular carcinoma: A retrospective cohort study

Table 1 Baseline demographic, laboratory, clinical and tumour staging characteristics of 320 untreated hepatocellular carcinoma patients (mean ± SD) n (%)

Variable	Patients (n = 320)
Age (yr)	68 ± 9.8
Sex
Male	226 (71)
Female	94 (29)
Etiology of cirrhosis
Hepatitis C only	241 (75)
Hepatitis B only	27 (8)
Alcohol abuse only	12 (4)
Multiple	9 (3)
Other	31 (10)
Biopsy-proven HCC diagnosis	60 (19)
Non-invasive HCC diagnosis	260 (81)
ECOG performance status1
0	94 (30)
1-2	123 (38)
3-4	103 (32)
Hepatic encephalopathy
None	271 (85)
Grades I-II	39 (12)
Grades III-IV	10 (3)
Ascites
Absent	151 (48)
Slight	122 (38)
Moderate-severe	47 (14)
Child-pugh score	8 ± 2
Child-pugh classes
A	105 (33)
B	142 (44)
C	73 (23)
Albumin (g/dL)	3.1 ± 0.6
International normalized ratio	1.4 ± 0.4
Total bilirubin (mg/dL)	2.8 ± 4.2
Platelet × 103/mmc	112 ± 80
Uninodular HCC	131 (41)
Multinodular HCC	189 (59)
Single lesion > 10 cm	34 (11)
Macroscopic vascular invasion and/or extrahepatic spread	100 (31)
AFP (ng/mL)
Median	35
Range	1-115.000
AFP ≥ 200 ng/dL	79 (24)
BCLC stage
A (early)	39 (12)
B (intermediate)	55 (17)
C (advanced)	124 (39)
D (end-stage)	102 (32)
CLIP score
0	23 (7)
1	49 (15)
2	127 (40)
3	67 (21)
4	34 (11)
5	17(5)
6	3 (1)

¹Eastern Cooperative Oncology Group-Performance Status. AFP: α fetoprotein; BCLC: Barcelona Clinic Liver Cancer; CLIP: Cancer of LiverItalian Program; HCC: Hepatocellular carcinoma; ECOG: Eastern Cooperative Oncology Group.

Table 2 Summary of follow-up in 320 untreated hepatocellular carcinoma patients (%)

Outcome	Patients (n = 320)
Death	292 (91)
Overall survival
Median (95% CI) (mo)	6.8 (5.8-7.7)
1-yr survival rate	32
2-yr survival rate	13
BCLC A (early stage) survival
Median (95% CI) (mo)	33 (20-46)
1-yr survival rate	100
2-yr survival rate	57
3-yr survival rate	41
BCLC B (intermediate stage) survival
Median (95% CI) (mo)	17.4 (14.8-20)
1-yr survival rate	79
2-yr survival rate	22
3-yr survival rate	5
BCLC C (advanced stage) survival
Median (95% CI) (mo)	6.9 (6.3-7.3)
1-yr survival rate	12
BCLC D (end-stage) survival
Median (95% CI) (mo)	1.8 (1.2-2.4)
1-yr survival rate	0

BCLC: Barcelona Clinic Liver Cancer classification.

Table 3 Multivariate Cox-regression models for predicting over all survival in 320 patients with hepatocellular carcinoma patients in cirrhosis

Variable	HR	95% CI	P value
Performance status1	2.875	2.547-3.245	< 0.0001
INR	1.811	1.328-2469	0.0001
Log-(AFP)	1.078	1.018–1.142	0.009
Albumin	-	-	-
Total Bilirubin	-	-	-
Presence of ascites	-	-	-

¹Eastern Cooperative Oncology Group-Performance Status. HR: Hazard ratio; INR: International Normalized Ratio; AFP: α fetoprotein.