Factors Relating to Tumor Size and Survival in Patients with Hepatocellular Carcinoma: Significance of Platelet-Lymphocyte Ratio, Portal Vein Thrombosis, and Albumin.

[INTRODUCTION] Maximum tumor diameter (MTD) is one of the key aggressiveness features of hepatocellular carcinoma (HCC). However, the clinical associations and causes of large size HCC are not well understood. The aim was to compare small and large MTD (≤/>6 cm) HCCs with respect to clinical associations.

[METHODS] MTD ≤/> 6 cm HCCs were compared by clinical characteristics and analyzed through logistical regression models, as well as Cox proportional hazard models for death, on clinical parameters.

[RESULTS] Patients with larger HCCs had more portal vein thrombosis (PVT) and tumor multifocality, higher AST, ALKP and GGT levels and lower albumin levels. A logistic regression model of MTD (≤/>6 cm) showed the highest risk for PVT and platelet-lymphocyte ratio (PLR) >150, while albumin and female gender were protective. The combination of male gender, PLR >150, plus PVT had an odds ratio of 12.124. In Cox proportional hazard models, the highest hazard ratio for death was for PVT, and only albumin was significantly protective. PVT plus low albumin had a hazard ratio of 4.254.

[CONCLUSION] PVT, albumin, PLR, and gender were significant for ≤/>6 cm MTD. PVT and albumin were significant for survival.