Gastroentérologie Clinique et Biologique (2010) 34, 288—296 ORIGINAL ARTICLE Survival improvement in Child—Pugh C cirrhotic patients with hepatocellular carcinoma diagnosed during 1990—2002 Amélioration de la survie des patients atteints de carcinome hépatocellulaire sur cirrhose Child-Pugh C entre 1990 et 2002 I. Ollivier a,* , B. Dauvois a , L. Guittet b,c , S. Boutreux b,c , B. Dupont a , G. Launoy b,c , T. Dao a a Service d’hépatogastroentérologie, CHU, avenue Côte-de-Nacre, 14032 Caen cedex, France b Registre des tumeurs du Calvados, CHU, avenue Côte-de-Nacre, 14032 Caen cedex, France c ERI3 Inserm « cancers et populations », CHU, avenue Côte-de-Nacre, 14032 Caen cedex, France Available online 26 February 2010 Summary Objectives. — The aim of this study was to describe the evolution of diagnostic modalities, treatment and survival in cases of hepatocellular carcinoma (HCC) between 1990 and 2002 in Calvados. Methods. — All cases registered as HCC in the Calvados Tumour Registry from 1990 to 2002 were retrospectively reviewed. Incidence rates were standardized in comparison to the world reference population. The Kaplan—Meier method was used for survival analysis, and the log- rank test and Cox’s model were used to compare patient survival according to demographic and tumour characteristics, as well as diagnosis period. Multivariate analysis were performed to determine independent prognostic factors and to assess the impact of the diagnosis period on survival. Results. — From 1990 to 2002, 729 cases registered as HCC were retrospectively validated. Stan- dard incidence rates were 11.1/100,000 in men and 1.9/100,000 in women. Mean age was 66.6 ± 11.8 years. Cirrhosis was present in 90.4% of cases. The cause of cirrhosis was alco- hol in 66.8% of cases, HCV in 12.5%, HBV in 2.9%, haemochromatosis in 3.5%, and ‘‘other’’ in 13.1%. Curative treatment was possible in 14.7% of cases. Median survival was 7.15 months. On multivariate analysis, male gender, age greater than 70years, Child—Pugh C (advanced-stage) cirrhosis, portal or suprahepatic venous thrombosis, alpha-fetoprotein (AFP) level greater than 200ng/mL and non-curative treatment were poor prognostic factors. However, the diagno- sis period was a good prognostic factor, associated with survival improvement over time in Child—Pugh C patients independent of tumour size, but not in Child—Pugh A and B. ∗ Corresponding author. E-mail address: ollivierhourmand-i@chu-caen.fr (I. Ollivier). 0399-8320/$ – see front matter © 2010 Elsevier Masson SAS. All rights reserved. doi:10.1016/j.gcb.2010.01.005