Paraneoplastic syndromes in patients with hepatocellular carcinoma in Taiwan

BACKGROUND. Hepatocellular carcinoma (HCC) is the most common malignancy in Taiwan. Some patients may manifest paraneoplastic syndromes during the cli nical course of the disease. In this study, the authors evaluated the clini cal significance of these paraneoplastic syndromes, compared the prevalence of these syndromes between cases of hepatitis B virus (HBV)-related and he patitis C virus (HCV)-related HCC, and estimated significant predictors ass ociated with the syndromes. METHODS. Clinical data on 1197 HCC patients, including age, gender, Child-P ugh score, survival time, laboratory data (including liver biochemistry, he patitis markers, and serum or-fetoprotein [AFP]), and tumor features (inclu ding tumor size, portal vein thrombosis, and histologic pictures), were ret rospectively reviewed. RESULTS, A total of 232 of 1197 patients (19.4%) had paraneoplastic syndrom es. HCC patients with paraneoplastic syndromes had significantly higher ser um AFP; higher rates of initial main portal vein thrombosis, metastasis, an d bilobal tumor involvement; larger tumor volume; and shorter survival than those without these syndromes. Patients with HBV-related HCC had a signifi cantly higher prevalence of paraneoplastic syndromes than patients with HCV -related HCC (20.1% vs. 11.2%, P = 0.005). In a stepwise multivariate logis tic regression analysis, AFP >50,000 ng/mL and tumor volume >30% were signi ficant predictive variables associated with the presence of paraneoplastic syndromes in HCC patients. CONCLUSIONS, HCC patients with paraneoplastic syndromes usually had higher levels of serum AFP and larger tumor volumes than those without. Patients w ith HBV-related HCC had a significantly higher prevalence of paraneoplastic syndromes than those with HCV-related HCC. (C) 1999 American Cancer Societ y.