The Charlson Comorbidity Index is an Independent Prognostic Factor for Treatment-Naïve Hepatocellular Carcinoma Patients with Extrahepatic Metastases
Chang, Y.-s.; Huang, J.-s.; Yen, C.-l.; Wang, C.-h.; Lai, C.-h.; Wu, T.-h.; Lan, Y.-j.; Chang, P.-h.; Yeh, K.-y.
Hepato-Gastroenterology 62(140): 1011-1015
2015
ISSN/ISBN: 0172-6390 PMID: 26902047 Document Number: 682636
This study aimed to investigate the association between comorbidity, anti-cancer treatment, and overall survival in patients with hepatocellular carcinoma (HCC) with extrahepatic metastases. We retrospectively analyzed data from 57 patients diagnosed as having treatment-naïve stage IV HCC with extrahepatic metastases between 2007 and 2010. Comorbidity was assessed using two scoring systems, the Charlson comorbidity index (CCI) and the Kaplan-Feinstein index. Associations between comorbidity, demographic variables, treatment modality, and overall survival were analyzed. Univariate analysis showed that a CCI of ≥ 2 (P = 0.017), an Okuda score of II/III (P = 0.026), and the use of anti-cancer therapy (P = 0.039) was associated with overall survival. Fewer patients with a CCI of ≥ 2 received treatment (P < 0.001), and anti-cancer treatment of any modality did not show a survival benefit in these patients (P = 0.174). The multivariate analysis showed that a CCI of ≥ 2 was the only independent prognostic factor for overall survival (P = 0.043). The pre-treatment comorbidity status played an important role in overall survival because of its association with the administration of anti-cancer therapy. Therefore, comprehensive evaluation of comorbidities before treatment is recommended for HCC patients with extrahepatic metastases.