The Charlson Comorbidity Index is an Independent Prognostic Factor for Treatment-Naïve Hepatocellular Carcinoma Patients with Extrahepatic Metastases.

BACKGROUND/AIMS: This study aimed to investigate the association between comorbidity, anti-cancer treatment, and overall survival in patients with hepatocellular carcinoma (HCC) with extrahepatic metastases. METHODOLOGY: We retrospectively analyzed data from 57 patients diagnosed as having treatment-naïve stage IV HCC with extrahepatic metastases between 2007 and 2010. Comorbidity was assessed using two scoring systems, the Charlson comorbidity index (CCI) and the Kaplan-Feinstein index. Associations between comorbidity, demographic variables, treatment modality, and overall survival were analyzed. RESULTS: Univariate analysis showed that a CCI of ≥ 2 (P = 0.017), an Okuda score of II/III (P = 0.026), and the use of anti-cancer therapy (P = 0.039) was associated with overall survival. Fewer patients with a CCI of ≥ 2 received treatment (P < 0.001), and anti-cancer treatment of any modality did not show a survival benefit in these patients (P = 0.174). The multivariate analysis showed that a CCI of ≥ 2 was the only independent prognostic factor for overall survival (P = 0.043). CONCLUSIONS: The pre-treatment comorbidity status played an important role in overall survival because of its association with the administration of anti-cancer therapy. Therefore, comprehensive evaluation of comorbidities before treatment is recommended for HCC patients with extrahepatic metastases.

Body mass index above 24 is beneficial for the 6-month survival rate in hepatocellular carcinoma patients with extrahepatic metastases.

BACKGROUND AND OBJECTIVES: To investigate the effect of overweight status on the 6-month survival rate in patients with extrahepatic hepatocellular carcinoma (HCC). METHODS AND STUDY DESIGN: We retrospectively analyzed the records of 51 patients with hepatocellular carcinoma and extrahepatic metastases between 2007 and 2010 before treatment. The associations among overweight status (body mass index [BMI] >24 kg/m2), demographic variables, and survival outcome were analyzed by univariate and multivariate analysis. RESULTS: BMI>24 kg/m2 was significantly associated with the 6-month survival rate (p=0.042). Gender (p=0.149), Child Pugh classification (p=0.149), Okuda staging (p=0.093), and albumin concentration >3.5 mg/dL (p=0.082) showed marginal survival benefits in univariate analysis. Multivariate analysis confirmed that BMI >24 kg/m2 was an independent prognostic factor for the 6-month survival rate (p=0.03). CONCLUSIONS: BMI >24 kg/m2 was associated with an improved 6-month survival rate in patients with extrahepatic metastatic hepatocellular carcinoma.

Low body mass index at 3 months following adjuvant chemoradiation affects survival of postoperative locally advanced oral cavity cancer patients.

OBJECTIVES/HYPOTHESIS: To investigate the association between body mass index and outcomes such as recurrence and survival in postoperative locally advanced oral cavity cancer patients who underwent adjuvant chemoradiation. STUDY DESIGN: Retrospective analysis of patient data and outcomes. METHODS: We retrospectively analyzed the records of 61 stage III, IVA, and IVB oral cavity cancer patients who were treated with curative surgery and adjuvant chemoradiation between 2007 and 2009. Each patient's body mass index was recorded throughout the treatment duration and after its completion. The associations between demographic variables, body mass index, and survival outcomes were determined by univariate and multivariate analyses. RESULTS: Overall, body mass index decreased throughout the chemoradiation period and reached the nadir at 3 months after completion of therapy. Univariate analysis showed that patients with body mass index <18.5 kg/m(2) at 3 months after chemoradiation had significantly higher recurrence and decreased survival rates. Multivariate analysis confirmed that body mass index <18.5 kg/m(2) at this time point is an independent predictor for recurrence (P = .039) and overall survival (P = .043). CONCLUSIONS: Early recurrence can be predicted by malnourished status 3 months after treatment completion. Malnourishment has significant negative effects on overall survival in locally advanced postoperative oral cavity cancer patients who are undergoing adjuvant chemoradiation. After therapy is completed, nutritional guidance and care should be continued for patients with this advanced disease.