The impact of alpha-fetoprotein (AFP), child-turcotte-pugh (CTP) score and disease staging on the survival of hepatocellular carcinoma (HCC) patients: a retrospective cohort from single oncology center.
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BACKGROUND: Hepatocellular carcinoma (HCC) is the most common cause of cancer-related death in Saudi Arabia. Our study aimed to investigate the patterns of HCC and the effect of TNM staging, Alfa-fetoprotein (AFP), and Child-Turcotte Pugh (CTP) on patients' overall survival (OS). METHODS: A retrospective analysis was conducted on 43 HCC patients at a single oncology center in Saudi Arabia from 2015 to 2020. All patients had to fulfill one of the following criteria: (a) a liver lesion reported as definitive HCC on dynamic imaging and/or (b) a biopsy-confirmed diagnosis. RESULTS: The mean patient age of all HCC cases was 66.8 with a male-to-female ratio of 3.3:1. All patients were stratified into two groups: viral HCC (n = 22, 51%) and non-viral HCC (n = 21, 49%). Among viral-HCC patients, 55% were due to HBV and 45% due to HCV. Cirrhosis was diagnosed in 79% of cases. Age and sex did not significantly statistically differ in OS among viral and non-viral HCC patients (p-value > 0.05). About 65% of patients had tumor size >5 cm during the diagnosis, with a significant statistical difference in OS (p-value = 0.027). AFP was >400 ng/ml in 45% of the patients. There was a statistically significant difference in the OS in terms of AFP levels (p-value = 0.021). A statistically significant difference was also observed between the CTP score and OS (p-value = 0.02). CTP class B had the longest survival. BSC was the most common treatment provided to HCC patients followed by sorafenib therapy. There was a significant statistical difference in OS among viral and non-viral HCC patients (p-value = 0.008). CONCLUSIONS: The most common predictors for OS were the underlying cause of HCC, AFP, and tumor size. Being having non-viral etiology, a tumor size >5 cm, an AFP > 400 ng/mL, and a CTP score class C were all negatively associated with OS.