Prognostic utility of systemic inflammatory markers and chronic hepatitis C virus infection status in hepatocellular carcinoma patients treated with local ablation

Ali, Mohamed A. Mohamed; Harmsen, William S.; Morsy, Khairy Hammam; Galal, Ghada Moustafa; Therneau, Terry M.; Roberts, Lewis R.

doi:10.1186/s12885-021-09121-8

Cited by 5 publications

(5 citation statements)

References 48 publications

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“…Also, routine clinical evaluation can provide prognostic information for HCC. 17 , 18 T cells are the main component of TIL with anti-tumor and pro-tumor effects in HCC. Furthermore, CD8+, CD3+, CD4+, and Foxp3+ lymphocytes are widely studied TIL subsets.…”

Section: Discussionmentioning

confidence: 99%

Construction and Validation of TACE Therapeutic Efficacy by ALR Score and Nomogram: A Large, Multicenter Study

Li¹,

Guo²,

Su³

et al. 2023

JHC

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Background TACE and TACE with or without targeted immunotherapy are crucial comprehensive therapies for middle and advanced HCC. However, a reasonable and concise score is needed to evaluate TACE and TACE combined with systemic therapy in HCC treatment. Methods The HCC patients were grouped into two groups: training group (n = 778) (treated with TACE) and verification group (n = 333). The predictive value of baseline variables on overall survival was analyzed using COX model, and easy-to-use ALR (AST and Lym-R) scores. The best cut-off value of AST and Lym-R were determined using X-Tile software based on total survival time (OS) and further verified via a restricted three-spline method. Meanwhile, the score was further verified using two independent valid sets: TACE combined with targeted therapy and TACE with targeted combined immunotherapy. Results In multivariate analysis, baseline serum AST>57.1 (p < 0.001) and Lym-R≤21.7 (p < 0.001) were identified as independent prognostic factors. The OS of patients in the TACE pooled cohort with 0, 1, and 2 scores were 28.1 (95% CI 24–33.8) months, 15 (95% CI 12.4–18.6) months, and 7.4 (95% CI 5.7–9.1) months, respectively. The time-varying ROC curve based on ALR showed that the AUC values for predicting 1, -2-and 3-year OS were 0.698, 0.718, and 0.636, respectively. These results are confirmed in two independent valid sets of TACE combined with targeted therapy and TACE with targeted combined immunotherapy. And we established a nomogram after COX regression to predict the 1 -, 2- and 3-year survival time. Conclusion Our study confirmed that ALR score can predict the prognosis of HCC treated with TACE or TACE combined with systemic therapy.

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Section: Discussionmentioning

confidence: 99%

Construction and Validation of TACE Therapeutic Efficacy by ALR Score and Nomogram: A Large, Multicenter Study

Li¹,

Guo²,

Su³

et al. 2023

JHC

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“…Previous studies have demonstrated that the OS after thermal ablation is greatly influenced by the tumor microenvironment, a factor that has often been neglected in clinical studies. [ 60 , 61 ] It has also been proven that a low lymphocyte-to-monocyte ratio (LMR), indicating higher monocyte/macrophage over lymphocytes in the tumoral stroma, is associated with poor survival outcomes after thermal ablation for liver cancer. [ 60 , 61 ] As none of the included studies in this NMA has considered the impact of pre-operative LMR, in light of the abovementioned evidence, there might be heterogeneity in OS outcomes between studies.…”

Section: Discussionmentioning

confidence: 99%

“…[ 60 , 61 ] It has also been proven that a low lymphocyte-to-monocyte ratio (LMR), indicating higher monocyte/macrophage over lymphocytes in the tumoral stroma, is associated with poor survival outcomes after thermal ablation for liver cancer. [ 60 , 61 ] As none of the included studies in this NMA has considered the impact of pre-operative LMR, in light of the abovementioned evidence, there might be heterogeneity in OS outcomes between studies. This issue is unavoidable until the pre-operative LMR is widely reported.…”

Section: Discussionmentioning

confidence: 99%

Efficacy and safety of single- and multiple-antenna microwave ablation for the treatment of hepatocellular carcinoma and liver metastases: A systematic review and network meta-analysis

Han

Zhao²,

Wu³

et al. 2022

Medicine

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Background: There is a myriad of microwave ablation (MWA) systems used in clinical settings worldwide for the management of liver cancer that offer a variety of features and capabilities. However, an analysis on which features and capabilities result in the most favorable efficacy and safety results has never been completed due to a lack of head-to-head comparisons. The aim of this study is to compare single-antenna and multiple-antenna MWA using radiofrequency ablation (RFA) as a common comparator in the treatment of very-early, early hepatocellular carcinoma (HCC) and ≤5 cm liver metastases. Methods: This network meta-analysis was performed according to PRISMA guidelines. PubMed, Cochrane, and Web of Science databases were searched for comparative studies. Complete ablation (CA) rate, local tumor progression-free (LTPF) rate, overall survival (OS), and major complication rate were assessed. Subgroup analyses were further performed based on synchronous or asynchronous MWA generators and tumor size (<2 cm or ≥2 cm). Results: Twenty-one studies (3424 patients), including 3 randomized controlled trials (RCTs) and 18 observational studies, met eligibility criteria. For CA, LTPF and major complications, as compared to single-antenna MWA, multiple-antenna MWA had relative risks (RRs) of 1.051 (95% CI: 0.987–1.138), 1.099 (95% CI: 0.991–1.246), and 0.605 (95% CI: 0.193–1.628), respectively. For 1-year and 3-year OS, as compared to single-antenna MWA, multiple-antenna MWA had odds ratios (ORs) of 0.9803 (95% CI: 0.6772–1.449) and 1.046 (95% CI: 0.615–1.851), respectively. Subgroup analysis found synchronized multi-antenna MWA was associated with significantly better LTPF by 22% (RR: 1.22, 95% CI 1.068, 1.421), and 21.4% (RR: 1.214, 95% CI 1.035, 1.449) compared with single-antenna MWA, and asynchronous multiple-antenna MWA, respectively, with more evident differences in larger tumors (≥2 cm). Conclusion: Multi-antenna and single-antenna MWA showed similar effectiveness for local treatment of liver tumors, but synchronous multi-antenna MWA exhibited better LTPF compared to other MWA approaches, particularly for larger liver tumors (≥2 cm). Large-scale RCTs should be further conducted.

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“…3 With a 1-8% annual risk in individuals with HCVinduced cirrhosis, chronic hepatitis C virus (HCV) is responsible for one-third of all HCCs worldwide. 4 So urgent need for noninvasive biomarkers is justified to facilitate the screening and early diagnosis of HCC post HCV.…”

Section: Introductionmentioning

confidence: 99%

Flow cytometry assessment of monocyte subsets alteration in hepatocellular carcinoma post hepatitis C virus infection

Ali

Hammad

Kotb

et al. 2022

EJI

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Hepatocellular carcinoma (HCC) is assumed to be an immunogenic malignancy since 90% of cases develop in environments with ongoing inflammation. Monocyte subsets contribute to tumoral immunity. Most HCC patients are discovered at late stages, which lowers their survival chances. We aimed to determine whether altered frequency of monocyte subsets contribute to post hepatitis C virus infection-liver cirrhosis (HCV-LC) development to HCC. This cross-sectional study enrolled 105 patients classified as post HCV-HCC (n=72) and post HCV-LC (n=33) patients. The monocyte subsets frequency was assessed by flow-cytometry. There was a significant increase in intermediate monocytes and decrease in non-classical monocytes in HCC group when compared to the LC group (P = 0.001 and 0.006, respectively). Intermediate monocyte frequency was positively correlated with cholesterol and triglycerides (r = 0.296, P < 0.002 and r = 0.247, P < 0.011, respectively). The receiver operating characteristic (ROC) curve revealed that intermediate monocytes percentage at a cutoff ≥ 0.625% and non-classical monocytes percentage at a cutoff ≤ 0.61% differentiated between patients with HCV-LC and those with HCV-HCC with a sensitivity of 76.4% and 69.4%, respectively, while both revealed low specificity of 51.5%. According to logistic regression analysis, only the triglyceride level was found to be an independent risk factor for HCC development [OR =1.014 (11.001–1.026), P = 0.031]. Finally, we concluded that post-HCV-HCC is characterized by an upregulation of intermediate monocytes and a downregulation of non-classical monocytes when compared to Post-HCV-LC. Intermediate and non-classical monocytes frequency can aid to screening biomarkers for HCC development. Intermediate monocyte frequency may be linked to hyperlipemia. The level of triglycerides is proposed as an independent risk factor for HCC emergence.

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Prognostic utility of systemic inflammatory markers and chronic hepatitis C virus infection status in hepatocellular carcinoma patients treated with local ablation

Cited by 5 publications

References 48 publications

Construction and Validation of TACE Therapeutic Efficacy by ALR Score and Nomogram: A Large, Multicenter Study

Construction and Validation of TACE Therapeutic Efficacy by ALR Score and Nomogram: A Large, Multicenter Study

Efficacy and safety of single- and multiple-antenna microwave ablation for the treatment of hepatocellular carcinoma and liver metastases: A systematic review and network meta-analysis

Flow cytometry assessment of monocyte subsets alteration in hepatocellular carcinoma post hepatitis C virus infection

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