A Comparison of Presentation, Treatment, and Survival After Hepatocellular Carcinoma of Viral and Non-Viral Etiology in Damietta, Egypt, 2007–2019

Figures & data

Table 1 General and Clinical Characteristics of Patients Diagnosed with HCC (Damietta, 2007–2019), Overall and by Etiology

		Overall	Etiology		P-value
			Viral	Non-Viral
		N = 4714	N = 4510	N= 204
General characteristics
Sex	Male	3650 (77.4%)	3498 (77.6%)	152 (74.5%)	0.3079
	Female	1064 (22.6%)	1012 (22.4%)	52 (25.5%)
Area of residence	Urban	1192 (25.3%)	1137 (25.2%)	55 (27.0%)	0.5788
	Rural	3518 (74.7%)	3369 (74.8%)	149 (73.0%)
	NA	NA: 4	NA: 4	NA: 0
Year of HCC diagnosis	<2014	2165 (45.9%)	2081 (46.1%)	84 (41.2%)	0.1639
	2014–2019	2549 (54.1%)	2429 (53.9%)	120 (58.8%)
Age at 1st visit in DOC	Median [Q25-Q75]	61 [55–67]	60 [55.00–67.00]	63.00 [56.00–69.00]	0.0029
	NA	4	4	0
Tobacco consumption	No	3038 (64.6%)	2916 (64.8%)	122 (60.1%)	0.1693
	Yes	1664 (35.4%)	1583 (35.2%)	81 (39.9%)
	NA	NA: 12	NA: 11	NA: 1
Clinical characteristics
Hypertension	No	3559 (76.5%)	3406 (76.4%)	153 (77.7%)	0.6907
	Yes	1094 (23.5%)	1050 (23.6%)	44 (22.3%)
	NA	NA: 61	NA: 54	NA: 7
Diabetes	No	3440 (73.9%)	3295 (73.9%)	145 (73.6%)	0.9191
	Yes	1214 (26.1%)	1162 (26.1%)	52 (26.4%)
	NA	NA: 60	NA: 53	NA: 7
History of gastroesophageal varices	No	3717 (83.5%)	3538 (83.3%)	179 (89.1%)	0.0311
	Yes	732 (16.5%)	710 (16.7%)	22 (10.9%)
	NA	NA: 265	NA: 262	NA: 3
Ascites	No	2785 (59.3%)	2649 (58.9%)	136 (67.7%)	0.0133
	Yes	1914 (40.7%)	1849 (41.1%)	65 (32.3%)
	NA	NA: 15	NA: 12	NA: 3
Encephalopathy	No	4408 (94.2%)	4212 (94.0%)	196 (97.5%)	0.0386
	Yes	273 (5.8%)	268 (6.0%)	5 (2.5%)
	NA	NA: 33	NA: 30	NA: 3
Imaging system used	CT Scan	4521 (95.9%)	4328 (96.0%)	193 (94.6%)	0.8150
	MRI	105 (2.2%)	99 (2.2%)	6 (2.9%)
	Both	50 (1.1%)	47 (1.0%)	3 (1.5%)
	NA	NA: 38	NA: 36	NA: 2
Clinical characteristics
Hepatic focal lesion (HFL) number	1	2069 (45.3%)	1980 (45.3%)	89 (44.7%)	0.5001
	2	559 (12.2%)	528 (12.1%)	31 (15.6%)
	3	112 (2.5%)	108 (2.5%)	4 (2.0%)
	>3 (multifocal)	1829 (40.0%)	1754 (40.1%)	75 (37.7%)
	NA	NA: 145	NA: 140	NA: 5
Vascular invasion	No	3717 (83.5%)	3380 (76.1%)	153 (75.7%)	0.9049
	Yes	732 (16.5%)	1061 (23.9%)	49 (24.3%)
	NA	NA: 265	NA: 69	NA: 2
Distant metastasis	No	3771 (81.6%)	3613 (81.7%)	158 (78.2%)	0.2063
	Yes	851 (18.4%)	807 (18.3%)	44 (21.8%)
	NA	NA: 92	NA: 90	NA: 2
Child-Pugh score	A	1727 (36.9%)	1656 (37.0%)	71 (35.5%)	0.5332
	B	1769 (37.8%)	1686 (37.7%)	83 (41.5%)
	C	1178 (25.2%)	1132 (25.3%)	46 (23.0%)
	NA	NA: 40	NA: 36	NA: 4
ECOG Stage	0	98 (2.1%)	96 (2.2%)	2 (1.0%)	0.2967
	1	1349 (29.5%)	1296 (29.6%)	53 (27.2%)
	2	1872 (41.0%)	1797 (41.1%)	75 (38.5%)
	3	1216 (26.6%)	1152 (26.4%)	64 (32.8%)
	4	31 (0.7%)	30 (0.7%)	1 (0.5%)
	NA	NA: 148	NA: 139	NA: 9
BCLC stage at diagnosis	0/A	766 (16.7%)	736 (16.8%)	30 (15.3%)	0.5189
	B	711 (15.5%)	681 (15.5%)	30 (15.3%)
	C	1353 (29.5%)	1286 (29.3%)	67 (34.2%)
	D	1755 (38.3%)	1686 (38.4%)	69 (35.2%)
	NA	NA: 129	NA: 121	NA: 8

Figure 1 Treatment option per BCLC stage and HCC etiology.

Table 2 Median, 6-, 12- and 24-Month Survival, per HCC Etiology

HCC Etiology	Median Survival Time (Months)	6-Month Survival	12-Month Survival	24-Month Survival
Viral (N=4510)	8.1 (7.8–8.4)	59% (57–60)	38% (36–39)	17% (16–19)
Non-viral (N=204)	6.2 (4.4–8.4)	51% (44–58)	35% (29–43)	15% (10–21)

Figure 2 Kaplan-Meier survival curves after HCC diagnosis, per etiology.

Table 3 Crude and Multi-Adjusted Cox Regression Model for Survival After HCC Diagnosis

Variable	Categories	Univariate Analysis			Multivariate Analysis
		cHR	95% CI	P-value	aHR	95% CI	P-value
Etiology	Non-viral vs viral	1.216	[1.052–1.406]	0.0081	1.244	[1.069–1.447]	0.0047
Sex	Female vs Male	0.838	[0.779–0.901]	<10^−3	0.97	[0.899–1.046]	0.4231
Year of diagnosis	2014–2019 vs <2014	0.983	[0.924–1.045]	0.5754	-
Area of residence	Rural vs urban	1.094	[1.020–1.173]	0.0116	0.986	[0.917–1.059]	0.6936
Age	10y increase	1.158	[1.117–1.200]	<10^−3	1.104	[1.065–1.144]	<10^−3
Hypertension	Yes vs no	0.824	[0.766–0.886]	<10^−3	0.922	[0.852–0.997]	0.0418
Diabetes	Yes vs no	0.907	[0.847–0.972]	0.0057	1.023	[0.951–1.100]	0.5414
BCLC stage at diagnosis	B vs 0/A	1.85	[1.649–2.076]	<10^−3	1.822	[1.621–2.048]	<10^−3
	C vs 0/A	3.532	[3.185–3.917]		3.466	[3.121–3.849]
	D vs 0/A	5.685	[5.139–6.289]		5.657	[5.102–6.273]

Abbreviations: cHR, crude Hazard Ratio; aHR, adjusted Hazard Ratio; CI, confidence interval.

Data Sharing Statement

Data related to this study are available upon a reasonable request through an Email to the corresponding author.