Prognostic factors for survival in patients with unresectable hepatocellular carcinoma undergoing chemoembolization with doxorubicin drug-eluting beads: a preliminary study

Dhanasekaran, Renumathy; Kooby, David A.; Staley, Charles A.; Kauh, John S.; Khanna, Vinit; Kim, Hyun S.

doi:10.1111/j.1477-2574.2009.00138.x

Cited by 44 publications

(32 citation statements)

References 25 publications

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“…reported 3‐year survival rates of 26% and 3%, respectively. The present study has confirmed that a reduction in serum AFP, 36 repetition of TACEs, 37,38 low MELD score, 39 the absence of diffuse disease 40,41 and small tumour size 42 are all associated with a better prognosis.…”

Section: Discussionsupporting

confidence: 83%

Quality of life and survival analysis of patients undergoing transarterial chemoembolization for primary hepatic malignancies: a prospective cohort study

Eltawil¹,

Berry

Abdolell

et al. 2012

HPB

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Introduction: Transarterial chemoembolization (TACE) is indicated for primary hepatic tumours when resection or local ablation are not feasible. Patients undergoing TACE have a better survival than best supportive therapy. However, there is paucity of prospective studies on the quality of life (QOL) after TACE for primary hepatic malignancies, especially in the Western world. Purpose: The primary aim of the present study was to determine if TACE impacts on the QOL of patients affected by primary hepatic tumours, and to assess treatment efficacy in a prospective cohort of patients treated at a tertiary Canadian university medical centre. Methods: From September 2005 to December 2010, 48 candidates for TACE underwent at least one TACE session. Data on their QOL, tumour response, serum alpha fetoprotein (AFP) and survival were prospectively collected every 3–4 months. Results: The overall QOL of patients undergoing TACE did not decline during the first 12 months after treatment. A decline was observed in the physical health domain after the third TACE that coincided with the increasing size of the largest tumour and a rise in the serum AFP levels. Psychological, social and environmental domains remained stable throughout the treatment period. Multivariate analysis revealed that tumour focality, AFP levels and model of end‐stage liver disease (MELD) scores were associated with long‐term survival (P= 0.001, P= 0.01, P= 0.02, respectively). The overall survival at 12, 36 and 48 months were 72%, 28% and 12%, respectively. Conclusion: TACE is an effective palliative intervention for unresectable and non‐ablatable primary liver tumours without affecting the QOL of patients even when repeated interventions are performed.

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Section: Discussionsupporting

confidence: 83%

Quality of life and survival analysis of patients undergoing transarterial chemoembolization for primary hepatic malignancies: a prospective cohort study

Eltawil¹,

Berry

Abdolell

et al. 2012

HPB

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“…CLIP score accounts for both tumor characteristics and liver function relevant to prognostic assessment for patients with HCC. As described in previous studies [30], [31], the present study showed that CLIP score before TACE was an independent factors associated with overall survival after TACE. The present study showed that the predictive ability of 1-year mortality by CLIP score was better than that by npRQ ratio.…”

Section: Discussionsupporting

confidence: 88%

Reduction in Non-Protein Respiratory Quotient Is Related to Overall Survival after Hepatocellular Carcinoma Treatment

et al. 2013

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BackgroundTranscatheter arterial chemoembolization (TACE) is an effective treatment for hepatocellular carcinoma (HCC) that can occasionally lead to the shortening of life expectancy. We aimed to make a new and more accurate prognostic model taking into account the course of disease after TACE.Methodology/Principal FindingsWe performed a prospective cohort study involving 100 HCC patients who underwent TACE at Kobe University Hospital. Indirect calorimetry and blood biochemical examinations were performed before and 7 days after TACE. Time-dependent and time-fixed factors associated with 1-year mortality after TACE were assessed by multivariate analyses. A predictive model of 1-year mortality was established by the combination of odds ratios of these factors. Multivariate analyses showed that the ratio of non-protein respiratory quotient (npRQ) (7 days after/before TACE) and Cancer of Liver Italian Program (CLIP) score were independent factors of 1-year mortality after TACE (p = 0.014 and 0.013, respectively). Patient-specific 1-year mortality risk scores can be calculated by summarizing the individual risk scores and looking up the patient-specific risk on the graph.ConclusionsThe short-term reduction of npRQ was a time-dependent prognostic factor associated with overall survival in HCC patients undergoing TACE. CLIP score was a time-fixed prognostic factor associated with overall survival. Using the prediction model, which consists of the combination of time-dependent (npRQ ratio) and time-fixed (CLIP score) prognostic factors, 1-year mortality risk after TACE would be better estimated by taking into account changes during the course of disease.

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“…The overall survival reported in this study reflects this inclusion of more patients with baseline poorer liver function. In other studies similar to this one with higher rates of advanced cirrhosis (34–63%) and survival rates range from 6–21 months 19–21 . In Dhanasekaran et al .…”

Section: Discussionsupporting

confidence: 62%

“…In Dhanasekaran et al . ‘s work on prognostic factors in doxorubicin‐bead TACE therapy in HCC, they found 7 out of 10 reported prognostic factors were associated with liver function rather than tumour stage 20 …”

Section: Discussionmentioning

confidence: 99%

Best radiological response to trans‐arterial chemoembolization for hepatocellular carcinoma does not imply better outcomes

Henry

Malhotra

Khabiri

et al. 2013

HPB

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Prognostic factors for survival in patients with unresectable hepatocellular carcinoma undergoing chemoembolization with doxorubicin drug-eluting beads: a preliminary study

Abstract: Child-Pugh class, Okuda staging, bilirubin > 2 mg/dl, albumin < 3 g/dl, MELD score, serum AFP, CLIP score, Milan criteria, ECOG PS and BCLC staging were found to be prognostic markers of survival after treatment with doxorubicin DEB TACE in patients with unresectable HCC.

Cited by 44 publications

References 25 publications

Quality of life and survival analysis of patients undergoing transarterial chemoembolization for primary hepatic malignancies: a prospective cohort study

Quality of life and survival analysis of patients undergoing transarterial chemoembolization for primary hepatic malignancies: a prospective cohort study

Reduction in Non-Protein Respiratory Quotient Is Related to Overall Survival after Hepatocellular Carcinoma Treatment

Best radiological response to trans‐arterial chemoembolization for hepatocellular carcinoma does not imply better outcomes

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