Transarterial chemoembolization can prolong survival for patients with metastatic hepatocellular carcinoma: a propensity score matching analysis

Lee, I‐Cheng; Huo, Teh–Ia; Huang, Yi Hsiang; Chao, Yee; Li, Chung–Pin; Lee, Pui–Ching; Chiang, Jen–Huey; Su, Chien–Wei; Lan, Keng‐Hsin; Yang, Chih-Ming Ou; Wu, Jaw–Ching; H, Lin; Lee, Shou‐Dong

doi:10.1007/s12072-011-9322-7

Cited by 22 publications

(18 citation statements)

References 29 publications

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“…The diagnosis of HCC and TACE eligibility was assessed before TACE using contrast‐enhanced computed tomography (CT) or magnetic resonance imaging (MRI), which fulfilled the diagnostic criteria of the American Association for the Study of Liver Diseases (AASLD) treatment guidelines for HCC . TACE was done through selective hepatic arterial catheterization and carried out with adjuvant Adriamycin . Whenever possible, the arteries supplying the tumour(s) were catheterized super‐selectively, followed by infusion of 5‐10 mL lipiodol (Laboratoire Guerbet).…”

Section: Methodsmentioning

confidence: 99%

“…23 TACE was done through selective hepatic arterial catheterization and carried out with adjuvant Adriamycin. 22,24 Whenever possible, the arteries supplying the tumour(s) were catheterized super-selectively, followed by infusion of 5-10 mL lipiodol (Laboratoire Guerbet). The feeding arteries were then embolized with 2-3 mm strips of gelfoam (Upjohn Co.).…”

Section: Introductionmentioning

confidence: 99%

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A new ALBI‐based model to predict survival after transarterial chemoembolization for BCLC stage B hepatocellular carcinoma

Lee

Hung

Liu

et al. 2019

Liver International

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Background & Aims Transarterial chemoembolization (TACE) is a standard treatment for Barcelona Clinic Liver Cancer (BCLC) stage B hepatocellular carcinoma (HCC), but the outcome varied. This study aimed to develop a model to predict the outcome of TACE in HCC patients. Methods Consecutive 570 treatment‐naïve BCLC stage B HCC patients undergoing TACE as the initial treatment from 2007 to 2016 were retrospectively enrolled. Factors associated with survival were analysed. Patients undergoing TACE from 2007 to 2011 constituted the training cohort (n = 293), while patients undergoing TACE from 2012 to 2016 constituted the validation cohort (n = 277). Homogeneity and corrected Akaike information criterion (AICc) were compared between each prognostic model. Results A total of 1796 TACE sessions were performed for the 570 patients during the median follow‐up period of 18.3 months. By multivariate analysis, beyond up‐to‐11 criteria (hazard ratio [HR] = 1.694, P < .001), alpha‐foetoprotein >200 ng/mL (HR = 1.771, P < .001) and albumin‐bilirubin (ALBI) grade 2 or 3 (HR = 1.817, P < .001) were independent predictors of overall survival (OS) in the training cohort. An ALBI‐TAE model based on the three independent predictors of OS from the training cohort was developed to classify HCC patients into four subgroups. The performance of the ALBI‐TAE model was superior to other prognostic models with lowest AICc values and highest homogeneity in both the training and validation datasets as well as the overall cohort. Conclusions Albumin‐bilirubin grade is an important factor associated with survival in BCLC stage B HCC patients undergoing TACE. ALBI‐TAE model can be applied to select patients who can get most benefit from TACE.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

A new ALBI‐based model to predict survival after transarterial chemoembolization for BCLC stage B hepatocellular carcinoma

Lee

Hung

Liu

et al. 2019

Liver International

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“…A recent retrospective study comparing standard sorafenib treatment, TACE, and TACE combined with radiation therapy in HCC patients with portal vein invasion showed that patients who underwent TACE combined with radiation therapy had longer median OS (383). Furthermore, there are retrospective studies showing that TACE is associated with survival gain, when intrahepatic HCC is treated with TACE in patients with extrahepatic metastasis (384385386). Recently, a Korean single center RCT reported that cTACE combined with radiation therapy significantly increased OS, the objective response rate (OSS), and time-to-progression (TTP) compared with sorafenib monotherapy in patients with HCC localized in the liver and portal vein invasion (387).…”

Section: Tace and Other Transarterial Therapiesmentioning

confidence: 99%

2018 Korean Liver Cancer Association–National Cancer Center Korea Practice Guidelines for the Management of Hepatocellular Carcinoma

2019

Korean J Radiol

203

128

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Hepatocellular carcinoma (HCC) is the fifth most common cancer globally and the fourth most common cancer in men in Korea, where the prevalence of chronic hepatitis B infection is high in middle-aged and elderly patients. These practice guidelines will provide useful and constructive advice for the clinical management of patients with HCC. A total of 44 experts in hepatology, oncology, surgery, radiology, and radiation oncology in the Korean Liver Cancer Association-National Cancer Center Korea Practice Guideline Revision Committee revised the 2014 Korean guidelines and developed new recommendations that integrate the most up-to-date research findings and expert opinions.

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“…Surgical resection is generally recommended for HCC [6], but is indicated only for patients with early stage and well preserved liver function. For patients not suitable for curative treatment, transarterial chemoembolization (TACE) may provide better loco-regional tumor control and increase patient survival [7]. …”

Section: Introductionmentioning

confidence: 99%

Prognostic role of noninvasive liver reserve markers in patients with hepatocellular carcinoma undergoing transarterial chemoembolization

Liu

Hsu

et al. 2017

PLoS ONE

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BackgroundVarious noninvasive liver reserve markers were proposed to indicate the severity of liver damage. However, the role and feasibility of these markers to predict the prognosis of patients with hepatocellular carcinoma (HCC) are unknown. We aimed to identify the prognostic role of the 8 currently used hepatic reserve markers in patients with HCC undergoing transarterial chemoembolization (TACE).MethodsBetween 2002 and 2013, a total of 881 patients with HCC undergoing TACE were prospectively identified and retrospectively analyzed. The baseline characteristics, tumor status and noninvasive markers were collected. Homogeneity and corrected Akaike information criteria (AICc) were compared between these markers. The Cox proportional hazards model was used to identify independent predictors of survival.ResultsSignificant differences in survival distribution were found for albumin-bilirubin (ALBI) grade, Child-Turcotte-Pugh (CTP) class, Lok index, fibrosis index based on 4 factors (FIB-4), Göteborg University cirrhosis index (GUCI), cirrhosis discriminant index (CDI) and model for end-stage liver disease (MELD) score (all p values <0.05). Among these markers, the ALBI grade showed the highest homogeneity and lowest AICc value, indicating a better prognostic performance. Cox multivariate analysis confirmed that ALBI grade 2, ascites, serum alkaline phosphatase and α-fetoprotein level, tumor diameter, vascular invasion and performance status were significant independent prognostic predictors. The distribution of the ALBI score well correlated with baseline CTP and MLED scores.ConclusionsOur data suggest that among the currently used liver reserve markers, ALBI grade may serve as an objective and feasible surrogate to predict the prognosis of HCC patients undergoing TACE.

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Transarterial chemoembolization can prolong survival for patients with metastatic hepatocellular carcinoma: a propensity score matching analysis

Abstract: TACE provides survival benefit for metastatic HCC patients. Prospective randomized controlled trials are warranted to delineate the role of combining TACE with sorafenib or other treatment for metastatic HCC.

Cited by 22 publications

References 29 publications

A new ALBI‐based model to predict survival after transarterial chemoembolization for BCLC stage B hepatocellular carcinoma

A new ALBI‐based model to predict survival after transarterial chemoembolization for BCLC stage B hepatocellular carcinoma

2018 Korean Liver Cancer Association–National Cancer Center Korea Practice Guidelines for the Management of Hepatocellular Carcinoma

Prognostic role of noninvasive liver reserve markers in patients with hepatocellular carcinoma undergoing transarterial chemoembolization

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