Follow-up of the patients admitted with liver masses of unknown origin to Gastroenterology clinic: A prospective study

Our study concentrated on the follow-up of all the patients who have admitted to Gastroenterology clinic with liver mass of unknown origin. We have followed the patients for 33 months with or without diagnosis, to evaluate the survival and factors that can affect the survival. Female and male patients with 18 years of age and above who have presented with liver masses for the first time to Gastroenterology clinic were included in this study. The patients who have diagnosed before and/or got treatment were excluded. Demographic features of the patients were recorded. Findings (laboratory, radiological and pathological) to determine the diagnosis of the mass, in Gastroenterology clinic and referred clinic which were referred from Gastroenterology, were recorded. Operations and oncologic treatment (chemotherapy/radiotherapy) if needed, survival time (month) and status (alive, dead) were recorded in patients with spesific etiology. During follow-up period, there weren't any intervention to diagnostic tests or treatments, only the datas were recorded and evaluated. Patients were categorized into three groups according to their diagnosis: 1) Benign masses of the liver, 2) primary malignant masses of the liver, 3) metastatic masses. Ninety six patients, 45 women (49,9%) and 51 men (53,1%), were included in our study. In the end of follow-up, 27 patients were alive (28,1%), and 69 patients (71,9%) were dead. 18,75% of the patients had benign masses and 81,25% of them had malignant masses. 8 of the patients with benign masses had good prognosis and did not require any therapies. In the end of the follow-up, all of the patients were alive and there weren't any complications. 43,5% of the malignant masses were primary (55,8% HCC, 44,2% cholangiocellular carcinoma) and 56,5% of them were metastatic tumours. In 44,3% of the patients with metastatic masses, origin of the masses were not found. When prognostic factors affecting survival were evaluated in malignant masses; being male, smoking, patients with BMI below 25 kg/m2, portal venous thrombosis, diameter of the mass> 50 mm, multipl masses, metastatic masses, total bilirubin level> 3 mg/dl, GPS 1-2, CRP> 10 mg/dl, CRP/albumin> 2, neutrofil/lymphocyte> 5, CA 19-9> 100 U/ml, CEA> 10 ng/ml were associated with poor prognosis and survival rates were lower. Relationship between survival rate and serum albumin level, plt/lymphocyte ratio was almost statistically significant. The survival rate of the patients with albumin below 3,5 gr/dl and plt/lymphocyte above> 200 were lower. nflammatory markers showing prognosis and survival rate, can be easily evaluated through laboratory tests like albumin, total bilirubin, complete blood count and biochemistry which show liver reserve capacity. Prognosis and survival rate of malignant tumours can be predicted with evaluation of prognosis factors. Keywords: Inflammatory markers, benign masses of liver, malignant masses of liver, prognosis, survival