Association between chemotherapy and prognostic factors of survival in hepatocellular carcinoma: a SEER population‑based cohort study

Background: Hepatectomy and transplantation are the main surgical therapies for HCC patients, and radiotherapy or chemotherapy is often used as the adjuvant treatment. Researches have evaluated the independent predictors of HCC, but evidence for factors predicting the efficacy of chemotherapy is rare. Methods: Patients diagnosed with HCC between 2010 and 2015 from the SEER database were included and randomly divided into non-chemotherapy and chemotherapy groups. The predictors of CSS and OS were analyzed with the Cox proportional-hazards regression model and Fine and Gray’s competing risk model. Results: Although there was no significant difference in survival analysis between the chemotherapy and non-chemotherapy groups, the cumulative cancer-specific mortality of most HCC patients were decreased in chemotherapy group. AJCC stage, tumor size, grade, surgery and radiotherapy were predictors of OS and CSS in non-chemotherapy group, while AJCC stage, tumor size, AFP, grade and surgery in chemotherapy group. Surgery combined with chemotherapy was applicable to all AJCC stage patients. Surgery was the major treatment option for patients in AJCC Ⅰ and AJCC Ⅱ stage, and chemotherapy in AJCC Ⅲ and AJCC Ⅳ stage. Conclusions: In conclusion, the study provided population-based estimates of the prognostic factors in HCC patients with or without chemotherapy.