Interaction of Gender and Hepatitis C in Risk of Chronic Renal Failure After Liver Transplantation
Autor: | Jayanthi Venkataraman, Chandan Kumar Kedarisetty, Joy Varghese, Mettu Srinivas Reddy, Thiruchunapalli Deepashree, Kaliamurthy Ilankumaran, Vijaya Srinivasan, Mohamed Rela, Sanjay Govil, Mangerira Chinnappa Uthappa |
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Rok vydání: | 2017 |
Předmět: |
Male
Tumour regression Time Factors Specialties of internal medicine Kidney Gastroenterology 0302 clinical medicine Calcineurin inhibitors Risk Factors Clinical endpoint Odds Ratio Liver transplant General Medicine Middle Aged Prognosis Hepatitis C Single centre Treatment Outcome RC581-951 030220 oncology & carcinogenesis Hepatocellular carcinoma Cohort 030211 gastroenterology & hepatology Female medicine.drug Glomerular Filtration Rate Sorafenib Adult medicine.medical_specialty Kidney failure Risk Assessment 03 medical and health sciences Sex Factors Internal medicine medicine Humans Adverse effect neoplasms Aged Retrospective Studies Chi-Square Distribution Hepatology British Columbia business.industry Gender medicine.disease digestive system diseases Liver Transplantation Logistic Models Kidney Failure Chronic business Progressive disease |
Zdroj: | Annals of Hepatology, Vol 16, Iss 2, Pp 230-235 (2017) |
ISSN: | 1665-2681 |
Popis: | Background and aim Transarterial chemoembolization (TACE) or sorafenib is recommended for hepatocellular carcinoma BCLC stages B and C respectively. We studied the role of combination of TACE and sorafenib in BCLC stages B/C. Material and methods We undertook an observational study on a cohort of cirrhotics with HCC from August 2010 through October 2014. Patients in BCLC stages B/C who had received TACE and/or sorafenib were included. mRECIST criteria were used to assess tumor response. The primary end point was overall survival. Results Out of 124 patients, 47.6% were in BCLC-B and 52.4% in BCLCC. Baseline characteristics were comparable. The predominant etiology was cryptogenic (37.2% and 38.5%, p = NS). 49.1% in BCLC-B and 56.9% in BCLC-C had received TACE+sorafenib. In BCLC-B, the overall survival improved from 9 months (95% CI 6.3-11.7) using TACE only to 16 months (95% CI 12.9-19.1) using TACE+sorafenib (p l 0.05). In BCLC-C, addition of TACE to sorafenib improved the overall survival from 4 months (95%CI 3-5) to 9 months (95%CI 6.8-11.2) (p l 0.0001). As per mRECIST criteria, patients on TACE+sorafenib had reduced progressive disease (37.8% vs. 83.3%), improved partial response (43.2% vs. 3.3%) and one had complete response compared to those on sorafenib alone (p l 0.0001) in BCLC-C but not in BCLC-B group. Hand foot syndrome was noted in 27.7% patients on sorafenib and post TACE syndrome in 80.2% patients, but both were reversible. No major adverse events were noted. Conclusion TACE+sorafenib was more effective than TACE or sorafenib alone in HCC BCLC stages B or C with a significant survival benefit and improved tumour regression especially in BCLC-C patients. |
Databáze: | OpenAIRE |
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