Characteristics and prognosis of hepatocellular carcinoma in multi-transfused patients with thalassemia major. Experience of a single tertiary center.

• Main Authors: Nikolaos Papadopoulos, Dimitrios Kountouras, Katerina Malagari, Maria Tampaki, Maria Theochari, John Koskinas
• Format: Article
• Language: English
• Published: PAGEPress Publications 2020-02-01
• Series: Mediterranean Journal of Hematology and Infectious Diseases
• Subjects: hepatocellular carcinoma (HCC), thalassemia major (TM), viral hepatitis, cirrhosis, hemosiderosis
• Online Access: http://www.mjhid.org/index.php/mjhid/article/view/4062

Background: In this retrospective study, records of patients with thalassemia major (TM) diagnosed with hepatocellular carcinoma (HCC) from 2008‐2018 were reviewed in order to determine the survival rate and evaluate possible etiological factors associated with survival. Methods: Forty-two TM patients who were diagnosed with HCC have been included in the study. Most of our patients (78.5%) were anti-HCV positive, while 16.5% had evidence of resolved HBV infection. At the time of HCC diagnosis, 78.5% of our patients were diagnosed with cirrhosis, while the vast majority (98%) had normal or mild elevated liver iron concentration (LIC) values. According to Barcelona Clinic Liver Cancer (BCLC) grading system patients were classified as 0-A: 28.5%, B: 57% and as C-D: 14.5%.  HCC has been treated with loco-regional treatment in 78.5% of our patients, while the rest have been treated with sorafenib. Results: Twenty-eight patients (66.5%) have eventually died with a median survival time of 6 months (range: 2-60). Using the Cox proportional hazard model, the only factors who have been associated with poor survival were BCLC stages C and D. Conclusions: In conclusion, BCLC staging is the main prognostic factor of survival in patients with TM who develop HCC, with a median survival time of six months.