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To investigate the prognostic factors in Western patients with hepatocellular carcinoma, 206 patients with confirmed diagnoses of hepatocellular carcinoma were studied in terms of survival. All patients were diagnosed between 1983 and 1987. A multivariate survival analysis (Cox regression model) using clinical, biochemical, ultrasonographical and pathological data obtained at diagnosis disclosed that bilirubin (p= 0.0001), ascites (p= 0.0001), toxic syndrome (defined by the presence of weight loss> 10% premorbid weight, malaise and anorexia)(p= 0.009), blood urea nitrogen (p= 0.025), tumor size (p= 0.001), γ-glutamyltranspeptidase (p= 0.0006), age (p= 0.0005), serum sodium (p= 0.003) and presence of metastases (p= 0.002) were independent predictors of survival. According to the contribution of each of these factors to the final model, a prognostic index was constructed allowing division of patients in …