Abstract

Aim. This study investigated the effect of tumor size and other factors on the survival and prognosis of hepatocellular carcinoma (HCC). Methods. All HCC populations based on the National Cancer Institute’s SEER database to receive from 2010 to 2016 were employed in the study. Results. This study enrolled a total of 14,634 HCC. Among them, 1,686 patients had tumors ≤ ۲ cm, 6,169 patients had tumors 2–۵ cm, and 6,779 patients had tumors > ۵ cm. The results using univariate analysis showed that all factors were significant prognostic factors for overall survival and specific survival. Patients with tumor size ≤ ۲ cm were more likely to survive, while patients with tumor size > ۵ cm had a lower survival rate. Patients who had surgery or surgery plus chemotherapy had a higher chance of survival in stages I-II, and the survival rate declined smoothly during the 80 months. The change rate of the mortality rate increased rapidly during the period of 1–۱۲ cm; afterwards, the mortality rate’s HR was basically and smoothly maintained at a high level. Conclusions. Tumor size was positively correlated with the mortality rate of HCC. Survival rates were greater in patients with tumors ≤ ۲ cm who underwent surgery or surgery plus chemotherapy. Patients with HCC in the early stage had a higher survival probability particularly when they had experienced surgery or surgery plus chemotherapy.

Introduction

Hepatocellular carcinoma (HCC) with an extremely high mortality rate is one of the most common malignant tumors. Previous study [1] showed the HCC has the poor of prognosis, and its survival rate of 5-year was under 20%. HCC has a special feature: growth with metastasis to distant organs, which accounts for poor survival. The HCC with distant metastasis is commonly found in the lungs, bones, and brain [2]. Moreover, the most common risk factor for HCC globally is the hepatitis B virus. In a previous study, the most common causative agent was the hepatitis C virus [3]. More than 90% of primary liver cancers are HCC [4]. In recent years, relevant research studies confirmed that specific therapeutic regimens, including surgical resection, chemotherapy, and radiotherapy, provided HCC patients favorable prognosis and long-term survival. The current meta-analysis from Francesca’s study [5] found that regorafenib was a safe and effective treatment option for patients with advanced HCC. In addition, the efficacy and safety of microwave ablation and radiofrequency ablation were similar, but microwave ablation reduced the long-term recurrence rate [6]. A review summarized the trajectory of various aspects of HCC management over the last 15 years, providing additional information for clinicians to aggregate [7]. Previous research studies [8] found that HCC patients were more likely to feel hopeless, depressed, and even have serious suicidal thoughts. HCC monitoring for national minority and individuals of lower socioeconomic status was poorly performed, further exacerbating the difference in HCC prognosis among these disadvantaged populations [9]. Current therapeutic regimens, including surgery of liver resection, transplantation, radiotherapy, percutaneous ethanol injection, transarterial chemoembolization, microwave ablation, radiofrequency ablation, cryoablation, irreversible electroporation, combination therapies (such as postoperative adjuvant chemoradiotherapy and nutrition supportive therapy) and palliative care, will create high costs for HCC [10].

Conclusions

This study revealed that the age of majority in HCC was over 50 years old, and the majority of HCC had solid tumor sizes of 2–۵ cm and not otherwise specified histology. The incidence of HCC in males was much higher than that in females, and whites also proved to be more than half the population at risk for HCC. Based on different stages, the majority of patients were in the early stages of HCC. Furthermore, HCC patients were distributed in above 2 cm, and the distribution of basic information for different tumor sizes was consistent with the overall populations. Single patients had more challenges than married patients. Otherwise, survival rates were greater in patients with tumor size ≤۲ cm who underwent surgery or surgery with chemotherapy. Patients with HCC in the early stage had a higher survival probability, particularly when they had undergone surgery or surgery plus chemotherapy. The most important thing was that we further determined that the larger the tumor, the greater the risk, and that surgical treatment was the major and critical of the three methods.