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Aim: Survival data for patients with hepatocellular carcinoma (HCC) is heterogeneous. We aimed to analyze the survival and cost of treatment in cirrhotic patients with HCC. Materials and methods: From May 1998 to March 2015, 157 patients with HCC diagnosed and treated in a single center were assessed retrospectively. Etiology, biopsy findings, Child-Pugh-Turcotte (CPT) scores, Barcelona Clinical Liver Cancer (BCLC) stages, treatment response, cost, and prognostic factors were recorded. Deaths due to complications of cirrhosis or other diseases were excluded. Results: 157 patients (82.8% male) with a mean age of 62.2±11.4 years at diagnosis were included. Etiology was HBV (56%), HCV (26.1%), cryptogenic (11.5%), and others (6.4%). Median lesion diameter was 4 (0.5-28) cm. 1, 2, and =3 lesions were present in 46.5%, 19.1%, and 34.2% of patients, respectively. Treatments were as follows: palliative (n: 53), transarterial chemoembolization-TACE (n: 53), radiofrequency ablation-RF (n: 14), radioembolization (n: 3), alcohol (n: 5), and chemotherapy (n: 14). Resection (n: 9) and transplantation (n: 6) were amenable in few patients. Before treatment, 114 (72.6%) patients were in the CPT A/B group, but 93 (59.3%) of all patients were initially staged as BCLC-C/D. Overall survival was 11.6±0.9 months, with 32% probability of surviving one year. Kaplan-Meier analysis revealed that pre-treatment CPT score, BCLC stage, TACE, and resection significantly affect survival. Cox regression defined BCLC stage (stage B: HR=9.58, 95% CI=1.03-88.98, p=0.047; stage C: HR=13.41, 95% CI=1.37-130.85, p=0.026, stage D: HR=24.72, 95% CI=2.33-262.46, p=0.008) and TACE (HR=2.36, 95% CI=1.18-4.71, p=0.015) as independent predictors of survival. Conclusion: Treatment modalities were not significantly different in terms of cost (p=0, 656). Hepatocellular carcinoma was usually diagnosed late, and treatment modalities were similar in cost. Barcelona clinical liver cancer stage and TACE were predictive of survival. [ABSTRACT FROM AUTHOR]

Objective: Hepatocellular cancer (HCC) is the most common malignancy of the hepatobiliary system. There are significant differences in the global spread of HCC. It is the major cause of death in patients with cirrhosis. Its molecular pathogenesis is highly complex and heterogeneous. Major risk factors for the development of HCC are chronic hepatitis B virus (HBV) infection, chronic hepatitis C virus (HCV) infection and alcoholrelated liver cirrhosis. Hepatocellular cancer is rarely seen in the first 4 decades of life, except in communities where HBV infection is hyperendemic. Methods: The study was conducted by retrospectively scanning the files of 204 patients diagnosed with HCC who applied to Organ Transplantation Center between 21.09.2014 and 13.04.2019. Patients were transplanted liver by being classified according to Milan criteria, San Francisco [University of California San Francisco (UCSF)] criteria, and Barcelona Clinic Liver Cancer (BCLC) criteria. Results: The median age of the patients was 58.03 (range 31 to 72). 170 of the patients were men and 34 of them were female. Liver transplantation (LT) was performed from cadaveric donors to 31 patients and from living donors to 173 patients. There is a significant relationship between the life span of the patients and their gender. Female patients have a longer life expectancy [t (202) = 2.963, p =0.003]. A significant relationship was found between life expectancy and surgical classification [F (3) = 3.008, (p =0.031)]. Conclusions: In patients diagnosed with HCC and undergoing LT; the gender being female and the classification method before transplantation affect life expectancy. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to evaluate the efficacy of transarterial chemoembolization (TACE) with drug-eluting beads in hepatocellular carcinoma (HCC). Material and Methods: Twenty-nine patients with HCC who were treated with TACE with drug-eluting beads between 2019 and 2021 were included in the study. The success of the TACE procedure was evaluated using pre- and post-operative contrast-enhanced computed tomography/magnetic resonance images. Patient characteristics, embolizing-bead sizes, procedure-related complications, and pre- and post-procedure alpha-fetoprotein (AFP) levels were recorded. Results: The mean age of the patients was 65.6±10.4 years, and the objective response rate was 17.2% (5/29). 100-300 μm particles were used in 11 (37.9%) patients, and 300-500 μm particles were used in 18 (62.1%). The median target lesion number was 1 (range, 1-6). Six (20.7%) patients had non-target lesions. There were newly developed lesions in four (13.8%) patients. A significant decrease was found in the median target lesion size after (41; range, 0-116 mm) the procedure compared to the pre- (42; range, 22-188 mm) procedure (p<0.001). A significant difference was found between the median AFP levels before (343; range, 1.44-2000 ng/mL) and after (52; range, 0.95-1435 ng/mL) the procedure (p<0.001). Conclusion: Since most patients with HCC are diagnosed in the intermediate stage, curative treatment is not possible. TACE is an important treatment option for the local control of the disease in this patient group. However, the success of TACE treatment may vary depending on the cancer stage, number of patients, follow-up period, and type and size of the microsphere used. [ABSTRACT FROM AUTHOR]