Open Access

ARTICLE

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

by NASSER MULLA^1,*, YOUSEF KATIB², ASIM M. ALMUGHAMSI³, DUAA S. ALKHAYAT¹, MOHAMED MOSAAD^1,4, SAMIR T. ALFOTIH⁵, RAWAN ALAOFI⁶

1 Department of Internal Medicine, Faculty of Medicine, Taibah University, Madinah, 42278, Saudi Arabia
2 Department of Radiology, Faculty of Medicine, Taibah University, Madinah, 42278, Saudi Arabia
3 Department of Surgery, Faculty of Medicine, Taibah University, Madinah, 42278, Saudi Arabia
4 Department of Endemic and Infectious Diseases, Suez Canal University, Ismailia, 41522, Egypt
5 King Salman bin Abdulaziz Medical City, Madinah, 42311, Saudi Arabia
6 Prince Mohammed Bin Abdulaziz Hospital, Madinah, 41511, Saudi Arabia

* Corresponding Author: NASSER MULLA. Email:

Oncology Research 2025, 33(1), 149-160. https://doi.org/10.32604/or.2024.050903

Received 21 February 2024; Accepted 08 May 2024; Issue published 20 December 2024

Abstract

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.

---

Keywords

---