Clinical and Translational Oncology

, Volume 15, Issue 9, pp 732–740 | Cite as

Defining prognostic factors of survival after external beam radiotherapy treatment of hepatocellular carcinoma with lymph node metastases

  • Y.-X. Chen
  • Z.-C. ZengEmail author
  • J. Fan
  • Z.-Y. Tang
  • J. Zhou
  • M.-S. Zeng
  • J.-Y. Zhang
  • J. Sun
Research Article



To identify independent predictors of survival in patients with lymph node (LN) metastases from hepatocellular carcinoma (HCC) after external beam radiotherapy (EBRT).


There were 191 patients with LN metastases from HCC received EBRT enrolled in the study cohort. EBRT was designed to focus on the LNs and a median dose of 50 Gy (range 40–60 Gy) was delivered. Treatment response was assessed by the WHO response criteria. Factors such as demographic data, tumor characteristics, and treatment modalities were determined before EBRT. Predictors of survival were identified by univariate and multivariate analysis.


The median survival was 8.0 months for all patients. Factors including Child-Pugh status (p = 0.009), intrahepatic tumor control (p = 0.015), LN location (p = 0.015), and response to EBRT (p < 0.001) were significant prognostic factors predicting for survival by multivariate analysis. The objective regression rate (ORR), which is the sum of complete and partial response rates, was as high as 79.1 %. As determined by multivariate analysis, the factors of LN location near liver (p = 0.002), smaller LN size (p = 0.021), and higher EBRT dose (p < 0.001) were associated with higher ORR values.


This study provides detailed information about survival outcomes and prognostic factors. Child-Pugh B value, uncontrolled intrahepatic tumor, LN location far from liver, and no response to EBRT are the unfavorable independent predictors.


Hepatocellular carcinoma External beam radiotherapy Prognostic Lymph node Metastasis 


Conflict of interest

No potential conflicts of interest exist.


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Copyright information

© Federación de Sociedades Españolas de Oncología (FESEO) 2013

Authors and Affiliations

  • Y.-X. Chen
    • 1
  • Z.-C. Zeng
    • 1
    Email author
  • J. Fan
    • 2
  • Z.-Y. Tang
    • 2
  • J. Zhou
    • 2
  • M.-S. Zeng
    • 3
  • J.-Y. Zhang
    • 1
  • J. Sun
    • 1
  1. 1.Department of Radiation Oncology, Zhongshan HospitalFudan UniversityShanghaiChina
  2. 2.Liver Cancer Institute, Zhongshan HospitalFudan UniversityShanghaiChina
  3. 3.Department of Radiology, Zhongshan HospitalFudan UniversityShanghaiChina

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