Predicting hepatocellular carcinoma recurrence and survival

Background: Beta blockers can inhibit tumor growth and metastases, while necroinflammation can enhance these tumor properties. Objective: To determine whether beta blockers and necroinflammatory disease predict tumor recurrence and/or overall survival following potentially curative therapeutic interventions for patients with hepatocellular carcinoma (HCC). Methods: The medical records of 36 adults with non-metastatic HCC who had undergone surgical resections and/or radiofrequency ablation (RFA) were retrospectively reviewed. In addition to post-intervention beta blocker usage and serum alanine aminotransferase levels greater than 2xULN, other variables commonly associated with recurrences such as number and size of tumors, state of differentiation and vascular invasion were included in univariate and multivariate analyses for recurrence and survival. Results: Vascular invasion (OR 29.3, 95% CI 2.6-33.6) and surgical resection (OR 0.19, 95% CI 0.04-0.90) emerged from univariate (p=0.003 and 0.03 respectively) and multivariate (p=0.005 and 0.048 respectively) regression as predictors of tumor recurrence whereas beta blocker usage (OR 0.03, 95% CI 0.04-0.9, p=0.03) and tumor recurrence (OR 6.7, 95% CI 1.6-28.1, p=0.026) correlated with overall survival. Conclusions: Neither beta blocker usage nor serum ALT levels predict HCC recurrences, but beta blocker usage is associated with improved overall survival following potentially curative therapeutic interventions for HCC in adults. Correspondence to: Dr. G.Y. Minuk, Department of Internal Medicine, University of Manitoba, John Buhler Research Centre, 715 McDermot Ave., Canada, E-mail: gminuk@cc.umanitoba.ca