Untreated hepatocellular carcinoma in Egypt: outcome and prognostic factors.

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.