A total of 850 patients with hepatocellular carcinoma seen during the last 8 years were analyzed retrospectively for survival in relation to treatment and disease stage. A new staging scheme based on tumor size, ascites, jaundice and serum albumin was used. Clearly, the prognosis depended on disease stage. The median survival of 229 patients who received no specific treatment was 1.6 months, 0.7 month for Stage III patients, 2.0 months for Stage II, and 8.3 months for Stage I. The median survival of Stage I patients who had hepatic resection (n = 115) was 25.6 months and Stage II patients with resection (n = 42) was 12.2 months. In patients who had a small cancer (less than or equal to 25% of liver area in size) the median survival was 29.0 months. Survival of the surgically treated patients, which represented a highly selected group, was better than that of medically treated patients of a comparable stage. Median survival of Stage I medically treated patients (n = 124) was 9.4 months, for Stage II (n = 290) 3.5 months, and for Stage III (n = 50) 1.6 months. Medical treatment prolonged survival in Stage II and III patients, but not in Stage I. Transcatheter arterial embolization gave a better survival compared with chemotherapy, whether intra-arterial bolus administration of mitomycin C, systemic mitomycin C, or oral/rectal tegafur, in Stage II. Among various chemotherapeutic modalities, intra-arterial bolus injection was superior to systemic chemotherapy in survival in Stage II. In Stage III, chemotherapy improved survival as compared with no specific treatment. The major causes of death were hepatic failure and gastrointestinal bleeding, probably due to the coexistent advanced cirrhosis. These results in survival are much improved over the past reports, and the differences are probably a result of earlier diagnosis and frequent hepatic resections.

Natural history of hepatocellular carcinoma and prognosis in relation to treatment study of 850 patients

Background
The risk of hepatocellular carcinoma (HCC) increases with increasing level of hepatitis B virus (HBV) in serum (viral load). However, it is unclear whether genetic characteristics of HBV, including HBV genotype and specific genetic mutations, contribute to the risk of HCC. We examined the HCC risk associated with HBV genotypes and common variants in the precore and basal core promoter (BCP) regions.

Associations Between Hepatitis B Virus Genotype and Mutants and the Risk of Hepatocellular Carcinoma

https://www.journal-of-hepatology.eu/article/S0168-8278(08)00565-5/pdf

Independent risk factors and predictive score for the development of hepatocellular carcinoma in chronic hepatitis B

https://www.gastrojournal.org/article/S0016-5085(02)15904-X/pdf

Basal core promoter mutations of hepatitis B virus increase the risk of hepatocellular carcinoma in hepatitis B carriers.

https://aasldpubs.onlinelibrary.wiley.com/doi/pdf/10.1002/hep.20956

Natural history of chronic hepatitis B virus infection: What we knew in 1981 and what we know in 2005

https://aasldpubs.onlinelibrary.wiley.com/doi/pdf/10.1002/hep.510290336

High prevalence of 1762T 1764A mutations in the basic core promoter of hepatitis B virus isolated from black africans with hepatocellular carcinoma compared with asymptomatic carriers

Michael C. Kew

Papers

High prevalence of 1762T 1764A mutations in the basic core promoter of hepatitis B virus isolated from black africans with hepatocellular carcinoma compared with asymptomatic carriers

Clinical, pathologic, and etiologic heterogeneity in hepatocellular carcinoma: Evidence from Southern Africa