Single determination of C-reactive protein at the time of diagnosis predicts long-term outcome of patients with hepatocellular carcinoma

Sieghart, Wolfgang; Pinter, Matthias; Hucke, Florian; Graziadei, Ivo; Schöniger–Hekele, Maximilian; Müller, Christian; Vogel, Wolfgang; Trauner, Michael; Peck‐Radosavljevic, Markus

doi:10.1002/hep.26057

Cited by 108 publications

(123 citation statements)

References 23 publications

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“…Prior the second TACE, most patients had Child-Pugh A cirrhosis (n ¼ 69, 62%). Overall, the median number of TACE interventions was 3 (range [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20]. The median time interval between the first and second TACE was 42 days (range 26-85).…”

Section: Resultsmentioning

confidence: 99%

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The ART of decision making: Retreatment with transarterial chemoembolization in patients with hepatocellular carcinoma

et al. 2013

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We aimed to establish an objective point score to guide the decision for retreatment with transarterial chemoembolization (TACE) in patients with hepatocellular carcinoma (HCC). In all, 222 patients diagnosed with HCC and treated with multiple TACE cycles between January 1999 and December 2009 at the Departments of Gastroenterology/Hepatology of the Medical Universities of Vienna (training cohort) and Innsbruck (validation cohort) were included. We investigated the effect of the first TACE on parameters of liver function and tumor response and their impact on overall survival (OS, log rank test) and developed a point score (ART score: Assessment for Retreatment with TACE) in the training cohort (n 5 107, Vienna) by using a stepwise Cox regression model. The ART score was externally validated in an independent validation cohort (n 5 115, Innsbruck). The increase of aspartate aminotransferase (AST) by >25% (hazard ratio [HR] 8.4; P < 0.001), an increase of Child-Pugh score of 1 (HR 2.0) or !2 points (HR 4.4) (P < 0.001) from baseline, and the absence of radiologic tumor response (HR 1.7; P 5 0.026) remained independent negative prognostic factors for OS and were used to create the ART score. The ART score differentiated two groups (0-1.5 points; !2.5 points) with distinct prognosis (median OS: 23.7 versus 6.6 months; P < 0.001) and a higher ART score was associated with major adverse events after the second TACE (P 5 0.011). These results were confirmed in the external validation cohort and remained significant irrespective of ChildPugh stage and the presence of ascites prior the second TACE. Conclusion: An ART score of !2.5 prior the second TACE identifies patients with a dismal prognosis who may not profit from further TACE sessions. (HEPATOLOGY 2013;57:2261-2273

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Section: Resultsmentioning

confidence: 99%

“…We recently demonstrated 15 that elevated C-reactive protein (CRP) values have a strong prognostic significance for patients with HCC. Thus, CRP values (<1 mg/dL and !1 mg/dL) prior the second TACE were included into statistical analysis.…”

Section: Methodsmentioning

confidence: 99%

The ART of decision making: Retreatment with transarterial chemoembolization in patients with hepatocellular carcinoma

et al. 2013

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“…Recent studies have showed that the preoperative elevated serum CRP level is an independent and significant predicative indicator of poor prognosis and early recurrence in patients with HCC (Hashimoto et al, 2005;Sieghart et al, 2013). However, SAA is superior to CRP for detecting inflammation resulting from viral infections, kidney transplantation, Crohn's disease, and ulcerative colitis (Yamada, 1999), and therefore SAA is probably more useful for detecting slight elevations in systemic or chronic inflammation.…”

Section: Discussionmentioning

confidence: 99%

Serum Amyloid A is a Novel Prognostic Biomarker in Hepatocellular Carcinoma

Ni¹,

Ye²,

Fu³

et al. 2015

Asian Pacific Journal of Cancer Prevention

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Purpose: To investigate the prognostic value of serum amyloid A (SAA) in patients with hepatocellular carcinoma (HCC) undergoing surgery. Materials and Methods: Preoperative serum samples of 328 patients with HCC who underwent curative resection and of 47 patients with benign liver lesion were assayed. Serum levels of SAA were measured by enzyme-linked immunosorbent assay and its correlations with clinicopathological characteristics and survival were explored. Results: Levels of SAA were significantly higher in patients with HCC than those with benign liver lesion. There were strong correlations between preoperative serum SAA level and tumor size and more advanced BCLC stage. On univariate analysis, elevated SAA was associated with reduced disease-free survival and overall survival (p=0.001 and 0.03, respectively). Multivariate analyses showed that serum SAA level was an independent prognostic factor for overall survival (hazard ratio 2.80, p=0.01). Conclusions: High SAA serum level is a novel biomarker for the prognosis of HCC patients.

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“…Chronically inflamed liver parenchyma due to various viral infections, deposition of substances such as copper and iron and chronic alcoholism, represents a precancerous environment (16). There is increasing evidence that the role of chronic systemic inflammation may be a significant predictor of outcome in various human malignancies, thus including HCC.…”

Section: Proposed Mechanisms In Role Of Rdw In Hccmentioning

confidence: 99%

“…There is increasing evidence that the role of chronic systemic inflammation may be a significant predictor of outcome in various human malignancies, thus including HCC. Multiple studies showed that elevated values of C reactive protein (CRP) predict survival (16,17) and recurrence (18) in HCC. Neutrophil-lymphocyte ratio (NLR), an easily obtainable inflammatory marker, is also proved to be associated with the prognosis of HCC (19).…”

Section: Proposed Mechanisms In Role Of Rdw In Hccmentioning

confidence: 99%

Prognostic value of red blood cell distribution width in hepatocellular carcinoma

Goyal

2017

Ann. Transl. Med.

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Red blood cell distribution width (RDW) is a simple, inexpensive, routinely measured and automatically reported blood test parameter, which reflects the degree of anisocytosis of red blood cells in peripheral blood. RDW was found to be associated with and retain clinical significance for assessing disease severity and outcomes in a number of hematological and solid malignancies. Motley of interacting clinical and biochemical factors have an impact on the red cell population biology. Malignancies per se can act as a causative factor, or anisocytosis may develop as a result of chronic inflammation. RDW has also been shown to be affected by nutritional status, which is typically deranged in malignancies. RDW is shown to be a clinically useful marker of disease severity and level of fibrosis in liver cirrhosis of various causes such as hepatitis B, hepatitis C and non-alcoholic fatty liver disease. Whether liver cirrhosis patients with higher RDW are at increased risk of hepatocellular cancer is yet to be determined, but several lines of evidence confirm that RDW has clinical significance in hepatocellular carcinoma (HCC). In this review, we specifically discuss the current literature about the association between RDW and HCC. The available evidences were summarized and the potential underlying mechanisms were analyzed.

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Single determination of C-reactive protein at the time of diagnosis predicts long-term outcome of patients with hepatocellular carcinoma

Cited by 108 publications

References 23 publications

The ART of decision making: Retreatment with transarterial chemoembolization in patients with hepatocellular carcinoma

The ART of decision making: Retreatment with transarterial chemoembolization in patients with hepatocellular carcinoma

Serum Amyloid A is a Novel Prognostic Biomarker in Hepatocellular Carcinoma

Prognostic value of red blood cell distribution width in hepatocellular carcinoma

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