Atike Pınar ERDOĞAN, Ferhat EKİNCİ, Ahmet ÖZVEREN, Ahmet ÖZVEREN, Cumali ÇELİK, Seval AKAY, Gamze GÖKSEL

Hepatosellüler Karsinomda Klinik ve Prognostik Özelliklerin Değerlendirilmesi: Tek Merkez Deneyimi

Giriş ve Amaç: Hepatoselüler karsinom (HCC), kanserin yaygın bir nedenidir ve çoğu HCC hastasında altta yatan siroz vardır. Retrospektif olarak kliniğimizde takipli HCC'li hastalarını karakterize etmeyi, sağkalımı araştırmayı ve sağkalım için öngörücü faktörleri belirlemeyi amaçladık. Gereç ve Yöntemler: Manisa Celal Bayar Üniversitesi Tıbbi Onkoloji Polikliniğinde 2014-2019 yılları arasında HCC teşhisi konan tüm hastalar geriye dönük olarak çalışmaya kaydedildi. Genel sağkalım Kaplan -Meier yöntemi kullanılarak hesaplandı. Sağkalım için öngördürücü faktörleri belirlemek için çok değişkenli Cox regresyon analizi yapıldı. Bulgular: Kliniğimizde takipli 40 HCC hastasının medyan tanı yaşı 66 olup %90’ı erkektir. Hepatit B virüs (HBV) enfeksiyonu en sık etyolojik sebeptir. C-Reaktif Protein (CRP) seviyesi daha yüksek olan hastaların sağkalım sürelerinin daha kısa olduğu görülmüştür. AFP düzeyi ile sağkalım arasında anlamlı korelasyon izlenmemiştir. Sonuç: Bölgemizde HBV’ye bağlı HCC’nin daha sık görüldüğü saptanmıştır. Hedefe yönelik tedavilerin umut vadettiği ve bu yönde prediktif belirteçlere ihtiyaç duyulduğu düşünülmektedir.

Anahtar Kelimeler:

hepatosellüler kanser, , Etyoloji, Tedavi, Prognoz

Evaluation of Clinical and Prognostic Features in Hepatocellular Carcinoma: A Single Center Experience

Objective: Hepatocellular carcinoma (HCC) is a common cause of cancer, and most of HCC patients have underlying cirrhosis. We aimed to retrospectively characterize patients with HCC who are followed up in our clinic, to investigate survival and to determine predictive factors for survival. Materials and Methods: All patients diagnosed with HCC in Manisa Celal Bayar University Medical Oncology Outpatient Clinic between 2014-2019 were enrolled in the study retrospectively. Overall survival was calculated using the Kaplan-Meier method. Multivariate Cox regression analysis was performed to determine predictive factors for survival. Results Median age at diagnosis of 40 HCC patients followed up in our clinic is 66 and 90% of them are male. Hepatitis B virus (HBV) infection is the most common etiological cause. It was observed that patients with higher C-Reactive Protein (CRP) levels had shorter survival times. There was no significant correlation between AFP level and survival. Conclusion: It has been determined that HCC due to HBV is more common in our region. It is thought that targeted therapies are promising and predictive markers are needed in this direction.

Keywords:

Etiology, Hepatocellular carcinoma, Prognosis, Treatment,

PDF

___

Bray, F, Ferlay, J, ve ark., Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries, A Cancer Journal for Clinicians, 2018, 68(6), 394-424.
London, W.T, Petrick, J.L, McGlynn, K.A, Liver cancer, In: Thun M.J, Linet, M.S, Cerhan, J.R, Haiman, C.A, Schottenfeld D, eds. Cancer Epidemiology and Prevention. 4th ed. New York: Oxford University Press; 2018, 635‐660.
Tang, A, Hallouch, O, Chernyak, V, Kamaya, A, Sirlin, C.B, Epidemiology of hepatocellular carcinoma: target population for surveillance and diagnosis. Abdominal Radiology (NY). 2018, 43(1), 13-25.
World Health Organization. Global Health Observatory (GHO) data: Hepatitis B 3rd Dose (HepB3) Immunization Coverage. Geneva: World Health Organization; 2017. who.int/gho/immunization/hepatitis/en/.
Vogeler, M, Mohr, I, Pfeiffenberger, J, Sprengel, S.D, Klauss, M,ve ark, Applicability of scoring systems predicting outcome of transarterial chemoembolization for hepatocellular carcinoma. Journal of Cancer Research and Clinical Oncology. 2020,146(4), 1033-1050.
Ayuso, C, Rimola, J, Vilana, R, Burrel, M,ve ark, Diagnosis and staging of hepatocellular carcinoma (HCC): current guidelines. European Journal of Radiology 2018, 101,72-81.
Llovet, J.M, Ricci, S, Mazzaferro, V, ve ark, Sorafenib in advanced hepatocellular carcinoma. New England Journal of Medicine 2008, 359, 378.
Personeni, N, Rimassa, L, Pressiani, T, ve ark, Molecular determinants of outcome in sorafenib-treated patients with hepatocellular carcinoma, Journal of Cancer Research and Clinical Oncology 2013, 139, 1179.
Bruix, J, Qin, S, Merle, P, ve ark, Regorafenib for patients with hepatocellular carcinoma who progressed on sorafenib treatment (RESORCE): a randomised, double-blind, placebo-controlled, phase 3 trial, Lancet 2017, 389, 56.
Stotz, M, Gerger, A, Eisner, F, ve ark, Increased neutrophillymphocyte ratio is a poor prognostic factor in patients with primary operable and inoperable pancreatic cancer. British Journal of Cancer, 2013,109, 416-421.
Azab, B, Mohammad, F, Shah, N, ve ark, The value of the pretreatment neutrophil lymphocyte ratio vs. platelet lymphocyte ratio in predicting the long-term survival in colorectal cancer, Cancer Biomarkers, 2014, 14, 303-312.
Shrotriya, S, Walsh, D, Nowacki, A.S, ve ark, Serum C-reactive protein is an important and powerful prognostic biomarker in most adult solid tumors, PLoS One, 2018, 13(8), e0202555.
Trevisani, F, DIntino, P.E, Morselli-Labate, A.M, ve ark, Serum a-fetoprotein for diagnosis of hepatocellular carcinoma in patients with chronic liver disease: Influence of HBsAg and anti-HCV status, Journal of Hepatology, 2001, 570–575.
Shao, Y.Y, Lin, Z.Z, Hsu, C, Shen, Y.C, Hsu, C.H, Cheng, A.L, ve ark., Early alpha-fetoprotein response predicts treatment efficacy of antiangiogenic systemic therapy in patients with advanced hepatocellular carcinoma, Cancer, 2010, 116, 4590-4596.