The Impact of Ascites Severity on Survival Outcome in Patients With Hepatocellular Carcinoma: A Retrospective Analysis. | ||
| Minia Journal of Medical Research | ||
| Articles in Press, Accepted Manuscript, Available Online from 30 October 2025 | ||
| Document Type: Original Article | ||
| DOI: 10.21608/mjmr.2025.435483.2116 | ||
| Authors | ||
| Mona Abd El-Rahman Abu El-Makarem1; Rania Bakry2; Hatem Ahmed Hassan3; Mahmoud Gamal Amin4; Alshymaa Ahmed Hassnine5; Nehal Ibrahim Abbas6; Eslam Sadek Farahat* 3 | ||
| 1Department of Internal Medicine, School of Medicine, Minia University, Minia, Egypt, | ||
| 2Department of Clinical Pathology, South Egypt Cancer Institue, Assiut University, Egypt | ||
| 3Department of Internal Medicine, Faculty of Medicine, Minia University, Minia, Egypt | ||
| 4Department of Pathology, South Egypt Cancer Institute, Assiut University, Assiut, Egypt | ||
| 5Department of Tropical Medicine, Faculty of Medicine, Minia University, Minia, Egypt. | ||
| 6Department of Clinical Pathology, Faculty of Medicine, Minia University | ||
| Abstract | ||
| Background: Hepatocellular carcinoma (HCC) represents a leading complication of chronic liver cirrhosis, where the development and severity of ascites not only reflect underlying hepatic dysfunction but also significantly impact patient survival. Aim of the Study: This retrospective case-control study was designed to assess the prognostic influence of ascites severity on overall survival of HCC patients. Subjects and Methods: The study cohort included a total of 90 participants and was divided into three equal groups: 30 cirrhotic patients with HCC, 30 cirrhotic patients without HCC, and 30 control subjects undergoing elective abdominal surgery without liver disease. Comprehensive clinical, laboratory, and radiological data were collected from patients’ medical files, and ascites was classified as none, mild, moderate, or severe using standardized imaging criteria. Results: The survival analysis revealed a clear dose-dependent relationship between ascites grade and patient survival. The average survival time was 13.6 months in patients without ascites, 8 months in those with moderate ascites, and approximately 4 months in patients with severe ascites. Multivariate Cox regression analysis confirmed that moderate and severe ascites were independently associated with increased mortality, with hazard ratios of 3.4 (95% CI: 1.1–10.2, p = 0.031) and 11 (95% CI: 1.1–108.5, p = 0.039) respectively. Additional factors, such as an advanced Child-Pugh class and tumor multiplicity, further contributed to poorer outcome. Conclusions: These findings underscore the critical importance of ascites quantification in the prognosis of HCC. Enhanced surveillance and tailored therapeutic strategies aimed at mitigating ascites may improve survival outcome in this high-risk population. | ||
| Keywords | ||
| Hepatocellular Carcinoma; Ascites; Liver Cirrhosis; Overall Survival | ||
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