Untreated hepatocellular carcinoma in Egypt: outcome and prognostic factors
Authors Zeeneldin A, Salem SE, Darwish A, El-Gammal M, Hussein M, Saadeldin M
Received 6 September 2014
Accepted for publication 14 October 2014
Published 30 January 2015 Volume 2015:2 Pages 3—9
Checked for plagiarism Yes
Review by Single-blind
Peer reviewer comments 3
Editor who approved publication: Dr Ahmed O Kaseb
Ahmed Abdelmabood Zeeneldin,1 Salem Eid Salem,1 Amira Diaa Darwish,1 Mosaad Mahmoud El-Gammal,1 Marwa Mahmoud Hussein,1 Mohamed Saadeldin2
1Medical Oncology/Hematology, National Cancer Institute, Cairo University, Cairo, Egypt; 2Medical Oncology, Tanta Cancer Center, Tanta, Egypt
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.
Aim: 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.
Conclusion: OS in untreated HCC in Egypt is very short. Many factors interact to produce this dismal survival.
Keywords: hepatocellular carcinoma, Egypt, prognosis, survival
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