The evaluation of prognostic risk factors in HBV-based cases with hepatocellular carcinoma

The Evaluation of Prognostic Risk Factors in HBV-Based Cases With Hepatocellular Carcinoma. Hacettepe University Faculty of Medicine, Thesis in Internal Medicine Department, Ankara, 2023. Objective: This study was aimed to evaluate the factors affecting survival in hepatitis b virus (HBV)-associated hepatocellular carcinoma (HCC) cases. Materials and Methods: Information of 114 patients who applied to our center between January 2012 and January 2021 and met the inclusion criteria of the study were collected. Data of cirrhotic patients (CP) and non-cirrhotic patient (NCP) groups were compared. Factors affecting survival were identified by log-rank and Cox regression analysis. Results: In univariate survival analysis; body mass index (BMI), AFP, bilirubin levels, AST, GGT, ALP, albumin, albumin to ALP ratio, neutrophil to lymphocyte ratio (NLR), longest tumor diameter, hypertension, infitrative tumor, ascites, meeting the Milan criteria and treatment type were associated with survival. 64 (%56,1) patients had cirrhosis and it was associated with reduced survival. In multivariate analysis; ALP, ascites, longest tumor diameter, AFP and albumin were independent factors affecting survival. CP and NCP were compared; albumin, leukocyte, neutrophil, platelet, albumin to ALP ratio and hypertension rate were higher in CP. Better survival were observed with incerased BMI level in NCP (p=0,005) whereas no affect on CP. Conclusion: Liver function tests, hemogram-related parameters, findings related to tumor burden, AFP, cirrhosis and its complications were found to afffect on survival in line with the literature. An increase in survival was observed with am incerase in BMI level in NCP and hypertension rate was found to be higher than im CP. Considering the absence of cirrhosis in ⁓30-50% of HBV-related HCC cases, further studies are needed for the survival effects of metabolic factors in non-cirrhotic patients. Keywords: Hepatitis B virus, Hepatocellular carcinoma, Survival, Liver cirrhosis