Comparison of the prognostic value of platelet-based prognostic models in patients with malignant hepatic tumors after TACE therapy

Purpose: To investigate the prognostic value of 17 platelet-based prognostic scores in patients with malignant hepatic tumors after TACE therapy. Methods: In total, 92 patients were divided into death group and survival group according to long-term follow-up results. The AUC was calculated to determine the optimal cut-off values for predicting prognosis. To determine better prognostic models, platelet-based models were analyzed separately after being showed as binary according to cut-off values. Cumulative survival rates of malignant hepatic tumors were calculated using Kaplan-Meier curves and differences were analyzed by the log-rank test. Univariate and multivariate analyses were performed to identify platelet-based prognostic scores associated with overall survival. Results: Univariate analysis showed that APGA, APRI, FIB-4, FibroQ, GUCI, Kings score, Lok index, PAPAS, cirrhosis, number of tumors, vascular cancer embolus, AFP, ALP and APTT were significantly related to prognosis. A multivariate analysis showed that the APGA, number of tumors, ALP and APTT were independently associated with overall survival. Conclusion: This study showed that the APGA, a platelet-based prognostic score, was an independent marker of prognosis in patients with malignant hepatic tumors after TACE and was superior to the other platelet-based prognostic scores in terms of prognostic ability.(AU)

Quimioembolização transarterial hepática: modelo experimental de tumor em ratos

PURPOSE: An animal model to study the behaviour of liver tumor in rat and its response after use of transarterial chemoembolization. METHODS: We use 88 Wistar rats, all of them were females, adult, weight 175-284 g. Abdominal incison of three cm and implanted the Walker carcinossarcoma 256 at left lobule of the liver. The animals were divided into three grups, that received 100x10³ , 200x10³, and 300x10³ cells. Followed up the animas to avaliate life standing and tumoral development. In another experiment was used 39 animals which already had Walker 256 tumor and we study the survival of the animals after treatment with 5-FU IP or 5-FU IA. RESULTS: The orevall tumor development rate were 100%. Tumor growth was fast, and devolopment metastases on old fase. The animals dead between 7º and 15º day. Its possible to do chemoembolization experimentaly, after the use of 5-FU the rate survival increased. CONCLUSION: The model with Walker 256 tumor developed here is easy to repoduce, efficient, with high tumor development rate observed, the life standing is about 9,96 ± 0,3 days. The chemoembolization experiment allows to assess several drugs.

OBJETIVO: Estabelecer um modelo de tumor no fígado de ratos para estudo do comportamento tumoral e avaliar o uso da quimiembolização transarterial. MÉTODOS: Utilizou-se oitenta e oito ratos Wistar, fêmeas, adultos, pesando entre 175- 284 g . Realizado incisão abdominal de 3 cm e implantou-se o carcinossarcoma de Walker 256 no lóbulo esquerdo do fígado. Dividiu-se em três grupos que receberam respectivamente 100x 10³ , 200x 10³ e 300x 10³ células tumorais, avaliado a pega do tumor e a sobrevida. Em outro grupo de experimento com 39 animais inoculados com tumor de Walker foi avaliado a sobrevida dos animais após infusão do 5-Flourouracil (5-FU) por via intra-peritoneal e intra-arterial. RESULTADOS: O implante do carcinossarcoma de Walker no fígado de ratos apresentou desenvolvimento de 100 %, teve um crescimento rápido e desenvolvimento de metástases tardiamente, levando os animais ao óbito entre o sétimo e décimo quinto dia. A quimiembolização transarterial é possível de ser realizada experimentalmente. O uso do 5-FU aumentou a sobrevida em comparação ao grupo controle. CONCLUSÃO: O modelo de implante do tumor de Walker no fígado de ratos é eficiente, de fácil reprodutibilidade, e sobrevida média de 9,96±0.3 dias. A quimioterapia transarterial hepática pode ser realizada experimentalmente para avaliar diversas drogas.