Tumor burden score as a new prognostic marker for patients with hepatocellular carcinoma undergoing transarterial chemoembolization.
J Gastroenterol Hepatol
; 36(11): 3196-3203, 2021 Nov.
Article
en En
| MEDLINE
| ID: mdl-34159651
ABSTRACT
BACKGROUND AND AIM:
Size and number are major determinants of tumor burden in hepatocellular carcinoma (HCC). Patients with HCC undergoing transarterial chemoembolization (TACE) have variable outcomes due to heterogeneity of tumor burden. Recently, tumor burden score (TBS) was proposed to evaluate the extent of tumor involvement. However, the prognostic accuracy of TBS has not been well evaluated in HCC. This study aimed to assess its prognostic role in HCC patients undergoing TACE.METHODS:
A total of 935 treatment-naïve HCC patients receiving TACE were retrospectively analyzed. Multivariate Cox proportional hazards model was used to determine independent prognostic predictors.RESULTS:
Tumor burden score tended to increase with increasing size and number of tumors in study patients. The Cox model showed that serum creatinine ≥ 1.2 mg/dL (hazard ratio [HR] 1.296, 95% confidence interval [CI] 1.077-1.559, P = 0.006), serum α-fetoprotein ≥ 400 ng/dL (HR 2.245, 95% CI 1.905-2.645, P < 0.001), vascular invasion (HR 1.870, 95% CI 1.520-2.301, P < 0.001), medium TBS (HR 1.489, 95% CI 1.206-1.839, P < 0.001) and high TBS (HR 2.563, 95% CI 1.823-3.602, P < 0.001), albumin-bilirubin (ALBI) grade 2-3 (HR 1.521, 95% CI 1.291-1.792, P < 0.001), and performance status 1 (HR 1.362, 95% CI 1.127-1.647, P < 0.001) and status 2 (HR 1.553, 95% CI 1.237-1.948, P < 0.001) were associated with increased mortality. Patients with high TBS had poor overall survival in Barcelona Clinic Liver Cancer stage B/C and different ALBI grades.CONCLUSIONS:
Tumor burden score is a feasible new prognostic surrogate marker of tumor burden in HCC and can well discriminate survival in patients undergoing TACE across different baseline characteristics.Palabras clave
Texto completo:
1
Bases de datos:
MEDLINE
Asunto principal:
Quimioembolización Terapéutica
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Carcinoma Hepatocelular
/
Carga Tumoral
/
Neoplasias Hepáticas
Tipo de estudio:
Observational_studies
/
Prognostic_studies
Límite:
Humans
Idioma:
En
Revista:
J Gastroenterol Hepatol
Asunto de la revista:
GASTROENTEROLOGIA
Año:
2021
Tipo del documento:
Article
País de afiliación:
Taiwán