Low applicability of the ��six-and-twelve score� in hepatocellular carcinoma treated with drug-eluting beads transarterial chemoembolization
| Autor: | Alicia Mesa, Serafín Marcos Costilla-García, Manuel Rodríguez, Andrés Castaño-García, María Luisa González-Diéguez, Carmen Álvarez-Navascués, V. Cadahía-Rodrigo, María Pipa-Muñiz, Susana Sanmartino, Mario Ernesto Piscoya-Díaz, Maria Varela |
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| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Carcinoma Hepatocellular Drug eluting beads business.industry medicine.medical_treatment Liver Neoplasms Gastroenterology Reproducibility of Results General Medicine Liver transplantation medicine.disease Methods observational Clinical Practice Treatment Outcome Hepatocellular carcinoma Internal medicine medicine Overall survival Humans Chemoembolization Therapeutic business Retrospective Studies |
| Zdroj: | Revista Española de Enfermedades Digestivas. |
| ISSN: | 1130-0108 |
| DOI: | 10.17235/reed.2021.7696/2020 |
| Popis: | Objective The effectiveness of transarterial chemoembolization (TACE) in hepatocellular carcinoma (HCC) depends on the selection of suitable patients. The ''Six-and-twelve score" distinguishes three groups of ideal patients with different overall survival based on the sum of number and size of tumors. This may impact clinical practice and trials design. The aim of the study is to assess the reproducibility and the prognostic value of the model in western patients treated with Drug-Eluting Beads (DEB)-TACE. Methods observational, retrospective, unicentric study developed in consecutive compensated patients treated with DEB-TACE from October/2008 to October/2017. Exclusion criteria were Child-Pugh ≥ 8 and DEB-TACE used as a bridge to liver transplantation. Results 225 HCC consecutive patients were included, BCLC-0/A n=131 (single nodules > 5, n=29), BCLC-B n=94. The median overall survival (OS) was 27 months (95% CI 23.8-30.2). OS was different between BCLC-0/A vs B: 30 vs 24 months (p= 0.03), Child-Pugh A5 vs A6-B7: 30 vs 27 months (p= 0.003). ''Six-and-twelve score" groups discriminated OS: group 1, n=123, 32 months (95% CI 27.5-63.5); group 2, n=101, 24 months (95% CI 19.6-28.4) and group 3, n=1, 27 months (p=0.024). When comparing the three scores, the ''Six-and-twelve score" showed the best discrimination power: C-index 0.603, Akaike's information criterion (AIC) 1.642, likelihood ratio test (LRT) 16.21. Conclusion The ''Six-and-twelve score" is a prognostic tool for patients with HCC treated with DEB-TACE. However, few patients were included in the third group (score >12) and no differences were observed with BCLC, therefore its applicability is limited. |
| Databáze: | OpenAIRE |
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