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Abstract Background We aimed to identify the main determinants of long-term overall survival (OS), including virologic control, and recurrence after radiofrequency ablation (RFA) of hepatocellular carcinoma (HCC) on cirrhosis. Methods Cirrhotic patients treated by RFA for HCC within Milan criteria were included. Associations between patient features and events were estimated by the Kaplan–Meier method with the log rank test and using uni/multivariate Cox models. Results 389 cirrhotic patients (Child–Pugh A 86.6%, 473 tumors) were included. OS was 79.8%, 42.4% and 16%, and overall tumor recurrence 45%, 78% and 88% at 2, 5 and 10 years, respectively. In multivariate analysis, age, Child–Pugh, GGT, HCC near major vessels, esophageal varices, alkaline phosphatase and HBV predicted OS. Gender, ALT, AFP and alcohol intake were associated with tumor recurrence. Multinodular HCC (19.5%) was associated with risk of tumor recurrence outside Milan criteria. HBV patients had longer OS than other patients (P = 0.0059); negative HBV PCR at RFA was associated with decreased tumor recurrence (P = 0.0157). Using time-dependent analysis in HCV patients, a sustained virologic response was associated with increased OS (124.5 months) compared to other patients (49.2 months, P < 0.001). Conclusion Virologic response and severity of underlying liver disease were the main determinants of long-term OS after RFA for HCC developing on cirrhosis. [ABSTRACT FROM AUTHOR]

Background Prognostic biomarkers are needed in a heterogeneous population of patients with intermediate hepatocellular carcinoma (HCC) treated by transarterial (chemo)embolization. We aimed to validate the prognostic value of serum CRP levels and the STATE score, combining CRP, albumin and tumor burden. Methods All cirrhotic patients with HCC treated by a first transarterial (chemo)embolization (2007–2013) in our institution were included. Overall survival was assessed using the Kaplan–Meier method, log rank, univariate and multivariate Cox analyses. Results Among 157 patients included, 87% were men, 86% had Child Pugh A. Etiologies of liver disease included alcohol (57%), hepatitis C (32%), hepatitis B (11%) and/or metabolic syndrome (32%); 89% of patients were classified BCLC B. 33% of the patients had a CRP >1 mg/dl and 33% a STATE score conferring poor prognosis (<18). Patients with CRP <1 mg/dl had better overall survival than patients with CRP >1 mg/dl (20 vs. 8 months, P = 0.00186). Median overall survival was 6.73 months for patients with a STATE score <18 vs. 22.23 months for patients with STATE-score ≥18 ( P = 0.0002). In multivariate analysis, a STATE score <18 was independently associated with increased mortality (HR: 2.06 (CI95%: 1.28–3.34), P = 0.0031). Conclusion In cirrhotic patients with HCC who underwent transarterial treatment, serum CRP level and STATE score at baseline can predict overall survival. [ABSTRACT FROM AUTHOR]

The article discusses a study on alcoholic cirrhosis, hepatocellular carcinoma, and the prognostic value of serum proteoglycans for carcinogenesis. Topics include serum vascular endothelial growth factor (VEGF), and the role of proteoglycans like endocan, syndeca-1, and glypican-3, in neoangiogenesis and transduction of oncogenic signals. The results show that serum endocan and syndecan-1 can function as prognostic serum biomarkers for hepatocellular carcinoma secondary to alcoholic cirrhosis.