Prognostic factor and risk stratification in hepatocellular carcinoma: insights from Cox regression and Kaplan-Meier analysis in a male-dominated cohort.

Abstract

Objective: Hepatocellular carcinoma (HCC) is a significant cause of morbidity and mortality worldwide. This study aims to comprehensively evaluate the prognostic factors influencing survival in patients diagnosed with HCC.

Patients and methods: This is a cross-sectional study aimed at identifying prognostic factors in HCC using Cox regression and Kaplan-Meier analysis. A cohort of 364 predominantly male HCC patients with a mean age of 61.6 ± 10.9 years was analyzed.

Results: Significant risk factors for mortality included HCV infection, alcoholism, elevated alpha-fetoprotein (AFP) and protein induced by vitamin K absence or antagonist-II (PIVKA) II levels, and a Child-Pugh score of 8. HCV-positive patients had a hazard ratio (HR) of 2.25. Average survival time was 32.99 ± 31.64 months, with 1, 2, and 3-year survival rates of 73.6%, 44.5%, and 31.3%, respectively. Patients with PIVKA-II levels ≤ 125 mAU/mL had a significantly higher 50% chance of surviving 42 months. Patients with the Barcelona clinic liver cancer (BCLC) stage B1 displayed a higher survival rate, except at the 24-month time point, with BCLC A and B1 groups showing survival rates exceeding 80% in the first year.

Conclusions: The findings provide valuable insights into the prognostic implications and risk stratification in HCC, facilitating personalized treatment decisions and potentially improving patient outcomes.