Development of a Prognostic Scoring System for Hepatocellular Carcinoma Patients With Main Portal Vein Tumor Thrombus Undergoing Conventional Transarterial Chemoembolization: An Analysis of 173 Patients
BackgroundPatients with hepatocellular carcinoma (HCC) with main portal vein tumor thrombus (mPVTT) have poor prognosis. Promising systemic therapies, such as target therapies, have limited benefits. The purpose of this study is to retrospectively evaluate the benefits of conventional TACE (c-TACE)...
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2021-08-01
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Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2021.671171/full |
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DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Jing-huan Li Jing-huan Li Jing-huan Li Xin Yin Xin Yin Xin Yin Wen-shuai Fan Wen-shuai Fan Lan Zhang Lan Zhang Lan Zhang Rong-xin Chen Rong-xin Chen Rong-xin Chen Yi Chen Yi Chen Yi Chen Li-xin Li Li-xin Li Li-xin Li Ning-ling Ge Ning-ling Ge Ning-ling Ge Yu-hong Gan Yu-hong Gan Yu-hong Gan Yan-hong Wang Yan-hong Wang Yan-hong Wang Zheng-gang Ren Zheng-gang Ren Zheng-gang Ren |
spellingShingle |
Jing-huan Li Jing-huan Li Jing-huan Li Xin Yin Xin Yin Xin Yin Wen-shuai Fan Wen-shuai Fan Lan Zhang Lan Zhang Lan Zhang Rong-xin Chen Rong-xin Chen Rong-xin Chen Yi Chen Yi Chen Yi Chen Li-xin Li Li-xin Li Li-xin Li Ning-ling Ge Ning-ling Ge Ning-ling Ge Yu-hong Gan Yu-hong Gan Yu-hong Gan Yan-hong Wang Yan-hong Wang Yan-hong Wang Zheng-gang Ren Zheng-gang Ren Zheng-gang Ren Development of a Prognostic Scoring System for Hepatocellular Carcinoma Patients With Main Portal Vein Tumor Thrombus Undergoing Conventional Transarterial Chemoembolization: An Analysis of 173 Patients Frontiers in Oncology hepatocellular carcinoma (HCC) portal vein tumor thrombus (PVTT) transarterial chemoembolization (TACE) overall survival (OS) prognosis model |
author_facet |
Jing-huan Li Jing-huan Li Jing-huan Li Xin Yin Xin Yin Xin Yin Wen-shuai Fan Wen-shuai Fan Lan Zhang Lan Zhang Lan Zhang Rong-xin Chen Rong-xin Chen Rong-xin Chen Yi Chen Yi Chen Yi Chen Li-xin Li Li-xin Li Li-xin Li Ning-ling Ge Ning-ling Ge Ning-ling Ge Yu-hong Gan Yu-hong Gan Yu-hong Gan Yan-hong Wang Yan-hong Wang Yan-hong Wang Zheng-gang Ren Zheng-gang Ren Zheng-gang Ren |
author_sort |
Jing-huan Li |
title |
Development of a Prognostic Scoring System for Hepatocellular Carcinoma Patients With Main Portal Vein Tumor Thrombus Undergoing Conventional Transarterial Chemoembolization: An Analysis of 173 Patients |
title_short |
Development of a Prognostic Scoring System for Hepatocellular Carcinoma Patients With Main Portal Vein Tumor Thrombus Undergoing Conventional Transarterial Chemoembolization: An Analysis of 173 Patients |
title_full |
Development of a Prognostic Scoring System for Hepatocellular Carcinoma Patients With Main Portal Vein Tumor Thrombus Undergoing Conventional Transarterial Chemoembolization: An Analysis of 173 Patients |
title_fullStr |
Development of a Prognostic Scoring System for Hepatocellular Carcinoma Patients With Main Portal Vein Tumor Thrombus Undergoing Conventional Transarterial Chemoembolization: An Analysis of 173 Patients |
title_full_unstemmed |
Development of a Prognostic Scoring System for Hepatocellular Carcinoma Patients With Main Portal Vein Tumor Thrombus Undergoing Conventional Transarterial Chemoembolization: An Analysis of 173 Patients |
title_sort |
development of a prognostic scoring system for hepatocellular carcinoma patients with main portal vein tumor thrombus undergoing conventional transarterial chemoembolization: an analysis of 173 patients |
publisher |
Frontiers Media S.A. |
series |
Frontiers in Oncology |
issn |
2234-943X |
publishDate |
2021-08-01 |
description |
BackgroundPatients with hepatocellular carcinoma (HCC) with main portal vein tumor thrombus (mPVTT) have poor prognosis. Promising systemic therapies, such as target therapies, have limited benefits. The purpose of this study is to retrospectively evaluate the benefits of conventional TACE (c-TACE) and to establish a prognostic stratification of HCC patients with mPVTT.MethodsThis is a single center retrospective study conducted over 5 years (duration of performing c-TACE), on consecutive HCC patients with mPVTT receiving c-TACE. Univariable and multivariable analysis were used to explore factors independently associated with overall survival (OS). Based on Cox-regression analysis, prognostic models were developed and internally validated by bootstrap methods. Discrimination and performance were measured by Akaike information criterion, concordance index, and likelihood ratio test.ResultsA total of 173 patients were included. Median OS was 6.0 months (95%CI: 3.92~8.08). The independent variables correlated with survival were largest tumor diameter, tumor number, mPVTT extension, and AFP. In the final model, patients were assigned 2 points if largest tumor diameter ≥8 cm, or tumor number ≥2, 1point if main trunk was complete obstructed, or AFP ≥400 ng/ml. By summing up these points, patients were divided into three risk groups according to the score at the 15rd and 85th percentiles, in which median OS were 18, 7, and 3.5months, respectively (p<0.001). The model shown optimal discrimination, performance, and calibration.Conclusionsc-TACE could provide survival benefits in HCC patients with mPVTT and the proposed prognostic stratification may help to identify good candidates for the treatment, and those for whom c-TACE may be futile. |
topic |
hepatocellular carcinoma (HCC) portal vein tumor thrombus (PVTT) transarterial chemoembolization (TACE) overall survival (OS) prognosis model |
url |
https://www.frontiersin.org/articles/10.3389/fonc.2021.671171/full |
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doaj-385a252f4b7d4f4db66afcf8993ab89e2021-08-27T23:44:08ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2021-08-011110.3389/fonc.2021.671171671171Development of a Prognostic Scoring System for Hepatocellular Carcinoma Patients With Main Portal Vein Tumor Thrombus Undergoing Conventional Transarterial Chemoembolization: An Analysis of 173 PatientsJing-huan Li0Jing-huan Li1Jing-huan Li2Xin Yin3Xin Yin4Xin Yin5Wen-shuai Fan6Wen-shuai Fan7Lan Zhang8Lan Zhang9Lan Zhang10Rong-xin Chen11Rong-xin Chen12Rong-xin Chen13Yi Chen14Yi Chen15Yi Chen16Li-xin Li17Li-xin Li18Li-xin Li19Ning-ling Ge20Ning-ling Ge21Ning-ling Ge22Yu-hong Gan23Yu-hong Gan24Yu-hong Gan25Yan-hong Wang26Yan-hong Wang27Yan-hong Wang28Zheng-gang Ren29Zheng-gang Ren30Zheng-gang Ren31Department of Hepatic Oncology, Liver Cancer Institute, Zhongshan Hospital, Fudan University, Shanghai, ChinaKey Laboratory of Carcinogenesis and Cancer Invasion, Ministry of Education, Shanghai, ChinaNational Clinical Research Center for Interventional Medicine, Shanghai, ChinaDepartment of Hepatic Oncology, Liver Cancer Institute, Zhongshan Hospital, Fudan University, Shanghai, ChinaKey Laboratory of Carcinogenesis and Cancer Invasion, Ministry of Education, Shanghai, ChinaNational Clinical Research Center for Interventional Medicine, Shanghai, ChinaDepartment of Orthopedics, Zhongshan Hospital, Fudan University, Shanghai, ChinaDepartment of Orthopedics, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, ChinaDepartment of Hepatic Oncology, Liver Cancer Institute, Zhongshan Hospital, Fudan University, Shanghai, ChinaKey Laboratory of Carcinogenesis and Cancer Invasion, Ministry of Education, Shanghai, ChinaNational Clinical Research Center for Interventional Medicine, Shanghai, ChinaDepartment of Hepatic Oncology, Liver Cancer Institute, Zhongshan Hospital, Fudan University, Shanghai, ChinaKey Laboratory of Carcinogenesis and Cancer Invasion, Ministry of Education, Shanghai, ChinaNational Clinical Research Center for Interventional Medicine, Shanghai, ChinaDepartment of Hepatic Oncology, Liver Cancer Institute, Zhongshan Hospital, Fudan University, Shanghai, ChinaKey Laboratory of Carcinogenesis and Cancer Invasion, Ministry of Education, Shanghai, ChinaNational Clinical Research Center for Interventional Medicine, Shanghai, ChinaDepartment of Hepatic Oncology, Liver Cancer Institute, Zhongshan Hospital, Fudan University, Shanghai, ChinaKey Laboratory of Carcinogenesis and Cancer Invasion, Ministry of Education, Shanghai, ChinaNational Clinical Research Center for Interventional Medicine, Shanghai, ChinaDepartment of Hepatic Oncology, Liver Cancer Institute, Zhongshan Hospital, Fudan University, Shanghai, ChinaKey Laboratory of Carcinogenesis and Cancer Invasion, Ministry of Education, Shanghai, ChinaNational Clinical Research Center for Interventional Medicine, Shanghai, ChinaDepartment of Hepatic Oncology, Liver Cancer Institute, Zhongshan Hospital, Fudan University, Shanghai, ChinaKey Laboratory of Carcinogenesis and Cancer Invasion, Ministry of Education, Shanghai, ChinaNational Clinical Research Center for Interventional Medicine, Shanghai, ChinaDepartment of Hepatic Oncology, Liver Cancer Institute, Zhongshan Hospital, Fudan University, Shanghai, ChinaKey Laboratory of Carcinogenesis and Cancer Invasion, Ministry of Education, Shanghai, ChinaNational Clinical Research Center for Interventional Medicine, Shanghai, ChinaDepartment of Hepatic Oncology, Liver Cancer Institute, Zhongshan Hospital, Fudan University, Shanghai, ChinaKey Laboratory of Carcinogenesis and Cancer Invasion, Ministry of Education, Shanghai, ChinaNational Clinical Research Center for Interventional Medicine, Shanghai, ChinaBackgroundPatients with hepatocellular carcinoma (HCC) with main portal vein tumor thrombus (mPVTT) have poor prognosis. Promising systemic therapies, such as target therapies, have limited benefits. The purpose of this study is to retrospectively evaluate the benefits of conventional TACE (c-TACE) and to establish a prognostic stratification of HCC patients with mPVTT.MethodsThis is a single center retrospective study conducted over 5 years (duration of performing c-TACE), on consecutive HCC patients with mPVTT receiving c-TACE. Univariable and multivariable analysis were used to explore factors independently associated with overall survival (OS). Based on Cox-regression analysis, prognostic models were developed and internally validated by bootstrap methods. Discrimination and performance were measured by Akaike information criterion, concordance index, and likelihood ratio test.ResultsA total of 173 patients were included. Median OS was 6.0 months (95%CI: 3.92~8.08). The independent variables correlated with survival were largest tumor diameter, tumor number, mPVTT extension, and AFP. In the final model, patients were assigned 2 points if largest tumor diameter ≥8 cm, or tumor number ≥2, 1point if main trunk was complete obstructed, or AFP ≥400 ng/ml. By summing up these points, patients were divided into three risk groups according to the score at the 15rd and 85th percentiles, in which median OS were 18, 7, and 3.5months, respectively (p<0.001). The model shown optimal discrimination, performance, and calibration.Conclusionsc-TACE could provide survival benefits in HCC patients with mPVTT and the proposed prognostic stratification may help to identify good candidates for the treatment, and those for whom c-TACE may be futile.https://www.frontiersin.org/articles/10.3389/fonc.2021.671171/fullhepatocellular carcinoma (HCC)portal vein tumor thrombus (PVTT)transarterial chemoembolization (TACE)overall survival (OS)prognosismodel |