Prognostic factors in hepatocellular carcinoma patients undergoing transarterial chemoembolization and radioembolization: a retrospective study
| Autor: | Rickmer Braren, Petia Jeliazkova, Mona Mustafa, Andreas Umgelter, Henrik Einwächter, Georgios Kaissis |
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| Rok vydání: | 2019 |
| Předmět: |
medicine.medical_specialty
Carcinoma Hepatocellular Hepatology Tumor size business.industry Proportional hazards model Liver Neoplasms Selective internal radiation therapy Gastroenterology Internal radiation Retrospective cohort study Prognosis medicine.disease Treatment Outcome Hepatocellular carcinoma Humans Medicine Radiology Liver function Chemoembolization Therapeutic Liver dysfunction business Retrospective Studies |
| Zdroj: | European Journal of Gastroenterology & Hepatology. 32:1036-1041 |
| ISSN: | 0954-691X |
| DOI: | 10.1097/meg.0000000000001625 |
| Popis: | OBJECTIVE Most patients with hepatocellular carcinoma are diagnosed at intermediate or advanced stages (BCLC B or C) and undergo palliative local treatments such as transarterial chemoembolization or selective internal radiation therapy, also called radioembolization. In terms of liver function and tumor extent, stages BCLC B and C comprise a wide spectrum of tumor manifestations. Predictors of survival in these patients undergoing transarterial chemoembolization and selective internal radiation therapy might help stratification into different prognostic groups and help to select the optimal treatment modality. METHODS In this retrospective study, all patients with hepatocellular carcinoma who underwent transarterial chemoembolization between January 2010 and December 2014 and all hepatocellular carcinoma patients who underwent selective internal radiation therapy between August 2012 and December 2016 were recruited. The prognostic value of pretherapeutic clinical and laboratory parameters for the prediction of overall survival was analyzed using uni- and multi-variable Cox regression models. RESULTS We enrolled 129 patients in the transarterial chemoembolization group and 34 patients in the selective internal radiation therapy group. The predictive value of the albumin-bilirubin grade was validated for both the transarterial chemoembolization and the selective internal radiation therapy group. Multivariable analysis identified albumin-bilirubin grade and tumor size as independent predictors for the transarterial chemoembolization group and tumor size, serum albumin and serum sodium as independent predictors for the selective internal radiation therapy group. CONCLUSION While measures of liver dysfunction predicted survival similarly in both cohorts, we found tumor size to predict survival differently in transarterial chemoembolization- and selective internal radiation therapy-treated patients. Tumor size might help to select the most appropriate treatment in hepatocellular carcinoma patients, although this finding has to be validated in further studies. |
| Databáze: | OpenAIRE |
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