Krebswissenschaft und -therapie

Liver Inflammation Parameters in Relation to Survival in Patients with Hepatocellular Carcinoma Tumor of differing Sizes

Abstract

Brian Carr, Vito Guerra, Ümit Karaoğullarından, Hikmet Akkiz, Volkan Ince, Burak Isik and Sezai Yilmaz

Introduction: Survival in patients with Hepatocellular Carcinoma (HCC) has been previously found to be worse with increase in tumor size, but also with increase in inflammation. To examine these issues separately, we aimed to study the influences on survival of various liver inflammation parameters in the whole cohort, and separately in patients with HCCs of defined Maximum Tumor Diameter (MTD).

Methods: A prospectively collected large database of Turkish HCC patients with documented survival was interrogated. Patients had baseline liver function tests and CT scans for tumor characteristics. Liver function and inflammation parameters included blood tests for levels of albumin, AST, GGT, ALKP, CRP, ESR and WBC.

Results: Survival was worse for patients with larger HCCs, including those with low or high serum AFP levels. Highest hazard ratios were found for patients with abnormal blood albumin (low) or AST (high) levels, regardless of AFP status. When patients were separately examined according to tumor size, only albumin and AST were significant for survival in patients with small <3cm tumors; whereas albumin, AST and ALKP were significant in patients with >3cm HCCs. Abnormal albumin or AST levels in different HCC size cohorts significantly related to percent patients with PVT, higher AFP or increased tumor focality, regardless of tumor size.

Results: Survival was worse for patients with larger HCCs, including those with low or high serum AFP levels. Highest hazard ratios were found for patients with abnormal blood albumin (low) or AST (high) levels, regardless of AFP status. When patients were separately examined according to tumor size, only albumin and AST were significant for survival in patients with small <3cm tumors; whereas albumin, AST and ALKP were significant in patients with >3cm HCCs. Abnormal albumin or AST levels in different HCC size cohorts significantly related to percent patients with PVT, higher AFP or increased tumor focality, regardless of tumor size.