International Journal of General Medicine (Jan 2022)

Factors Influencing Overall Survival for Patients with Fibrolamellar Hepatocellular Carcinoma: Analysis of the Surveillance, Epidemiology, and End Results Database

  • Polychronidis G,
  • Feng J,
  • Murtha-Lemekhova A,
  • Heger U,
  • Mehrabi A,
  • Hoffmann K

Journal volume & issue
Vol. Volume 15
pp. 393 – 406

Abstract

Read online

Georgios Polychronidis,1 Jincheng Feng,2 Anastasia Murtha-Lemekhova,1 Ulrike Heger,1 Arianeb Mehrabi,1 Katrin Hoffmann1 1Department of General, Visceral and Transplant Surgery, Heidelberg University Clinic, Heidelberg, Germany; 2Department of Hepatobiliary Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People’s Republic of ChinaCorrespondence: Katrin HoffmannDepartment of General, Visceral and Transplant Surgery, University of Heidelberg, Im Neuenheimer Feld 420, Heidelberg, 69120, GermanyEmail [email protected]: The study aimed to develop a nomogram to predict overall survival (OS) for patients with FLC using a national database.Methods: The Surveillance, Epidemiology, and End Results database of the National Cancer Institute was reviewed to identify FLC cases with histological confirmation between 2004 and 2014. Cox proportional hazards models were used to identify factors associated with OS. The validation of the nomogram was performed using concordance index (C-index) and calibration curves.Results: Out of 170 cases with complete follow-up, 87 received surgery/ablation and 12 received transplantation with significantly higher OS than chemotherapy alone while transplantation combined with chemotherapy showed better survival than solely transplantation. The combination of surgery and chemotherapy showed worse OS than surgery alone. Survival was negatively influenced by T4 stadium (HR = 5.91), while young age and surgery were positive predictive factors. There was no influence of gender, ethnicity or nodal status on survival. The rate of AFP positivity was comparable with and without the presence of distal metastases.Conclusion: FLC survival is greatly dependent upon appropriate surgical management irrespective of tumor stadium.Keywords: fibrolamellar, hepatocellular, carcinoma, SEER

Keywords