Prognostic factors in patients with advanced hepatocellular carcinoma receiving hepatic arterial infusion chemotherapy

Yamasaki, Takahiro; Kimura, Takeshi; Kurokawa, Fumie; Aoyama, Kouji; Ishikawa, Tsuyoshi; Tajima, Kunihiko; Yokoyama, Yuichiro; Takami, Taro; Ômori, Kaoru; Kawaguchi, Kotaro; Tsuchiya, Masako; Terai, Shuji; Sakaida, Isao; Okita, Kiwamu

doi:10.1007/s00535-004-1494-7

Cited by 63 publications

(101 citation statements)

References 38 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…It was reported that administration of lower doses of 5-FU for longer times was more effective in producing direct cytotoxic effects in human tumor cells than when administered at higher doses for shorter times [21]. Many investigators have reported the efficacy of this combination therapy for advanced HCC [22,23,24,25]. Okuda et al [26] reported that the CR rate and effective response rate of HAIC using cisplatin and 5-FU were 29.0 and 71.0%, respectively.…”

Section: Discussionmentioning

confidence: 99%

Hepatic Arterial Infusion Chemotherapy Using Low-Dose 5-Fluorouracil and Cisplatin for Advanced Hepatocellular Carcinoma

Ueshima¹,

Kudo²,

Takita³

et al. 2010

Oncology

View full text Add to dashboard Cite

Background: Although hepatic arterial infusion chemotherapy (HAIC) using low-dose 5-fluorouracil (5-FU) and cisplatin (low-dose FP) is commonly used for advanced hepatocellular carcinoma (HCC) with vascular invasion in Japan, few reports have investigated the efficacy and safety of this approach. We investigated the efficacy and toxicity of HAIC using low-dose FP for patients with advanced HCC as a phase II trial. Methods: Low-dose FP consisted of a continuous arterial infusion of 5-FU (250–500 mg/day, 5 days/week, for the first 2 weeks) and cisplatin (10 mg/day, 5 days/week, for the first 2 weeks). Then, 5-FU (1,000 mg/body for 5 h) and cisplatin (10 mg/body) were administered once weekly. Results: In these patients treated with low-dose FP, the response rate was 38.5%, the median time to progression was 4.1 months (95% CI 2.1–6.1 months) and the median survival time was 15.9 months (95% CI 9.8–22.0 months). The most frequent adverse events were myelosuppression such as neutropenia or thrombocytopenia. Conclusions: HAIC using low-dose FP is an effective treatment option for locally advanced HCC. However, it is not well tolerated hematologically because of potent pancytopenia and poor hepatic reserve. Therefore, this regimen should be performed carefully with regular monitoring of hematological function.

show abstract

Section: Discussionmentioning

confidence: 99%

Hepatic Arterial Infusion Chemotherapy Using Low-Dose 5-Fluorouracil and Cisplatin for Advanced Hepatocellular Carcinoma

Ueshima¹,

Kudo²,

Takita³

et al. 2010

Oncology

View full text Add to dashboard Cite

show abstract

“…However, in the US, where there is no national screening program, the majority of HCC patients present at an advanced phase of their disease, either due to the severity of the underlying cirrhosis or the extent of their HCC. There has not so far, to our knowledge, been a large prospective study of these advanced unresectable HCC patients; although, several small series having evaluated prognostic factors in these patients [8,20,[24][25][26][27][28][29].…”

Section: Introductionmentioning

confidence: 99%

Tumor and liver determinants of prognosis in unresectable hepatocellular carcinoma: a large case cohort study

2009

View full text Add to dashboard Cite

Objectives 967 patients with unresectable and untransplantable, biopsy-proven hepatocellular carcinoma (HCC) were prospectively evaluated at baseline and followed up till death. Survival was the end point. Results We found that male gender, ascites, cirrhosis, portal vein thrombosis (PVT), elevated AFP or bilirubin, or alkaline phosphatase, were each statistically significant adverse prognostic factors. Patients with normal AFP survived longer than those with elevated AFP, even in the presence of PVT, large or bilobar tumors or cirrhosis. We used a bivariate analysis to separate patient sub groups based on liver function and tumor characteristics and found clear discrimination in survival between subsets; in addition both cirrhosis and presence of PVT were significant factors. We also used a purely mathematical approach to derive subgroups and a prognostic model for individual patients. Interestingly, the two approaches gave similar predictive information, which opens the possibility of a more detailed mathematical analysis in the future. The results of this large dataset show that amongst non-surgical HCC patients, there are clear subsets with longer survival. Conclusion The data supports the concept of heterogeneity of HCC. The three factors, bilirubin, AFP, and PVT predominate in prognosis.

show abstract

“…15,16 However, an overall response rate to HAIC of 22 to 71% has been reported, 17 and HAIC is not effective for all patients. The median survival times reported in responders to HAIC was 18.4 to 31.6 months and in nonresponders, 5.4 to 6.7 months, 15,18 and the survival rate was significantly higher of responders than nonresponders. Thus, the prediction of patients' responses to HAIC would be very useful.…”

Section: Introductionmentioning

confidence: 87%

Significance of the Signal Intensity of Gadoxetic Acid-enhanced MR Imaging for Predicting the Efficacy of Hepatic Arterial Infusion Chemotherapy in Hepatocellular Carcinoma

Fujita

Nishie

Asayama

et al. 2016

MRMS

View full text Add to dashboard Cite

Purpose: We attempted to clarify the relationship between the signal intensity (SI) in the hepatobiliary phase of gadoxetic acid-enhanced magnetic resonance (MR) imaging and the efficacy of hepatic arterial infusion chemotherapy (HAIC) in hepatocellular carcinomas (HCCs).Methods: We enrolled 14 patients with HCCs who underwent gadoxetic acid-enhanced MR imaging prior to HAIC using cisplatin and 5-fluorouracil. In the hepatobiliary phase, we calculated the SI of the HCCs and the background liver. In cases with multiple HCCs, we calculated the SI of the largest lesion. Patients were classified into high (n = 7) and low intensity (n = 7) groups based on the median value of the SI ratio (SI of the tumor/SI of the background liver). We analyzed progression-free survival using the Kaplan-Meier method and the log-rank test. In the 5 patients with a history of HCC surgery, we compared the expression of immunohistochemical organic anion-transporting polypeptide (OATP) 8 between the high and low intensity groups by chi-square test.Results: The SI ratios were 0.568 « 0.093 (mean « standard deviation) in the high intensity group and 0.251 « 0.086 in the low intensity group. Compared to the group with low signal intensity, the group with high signal intensity demonstrated significantly lower serum levels of alpha fetoprotein (AFP) (P = 0.0350), significantly higher progressionfree survival (P = 0.0108), better differentiation of tumor grade at histologic examination (P = 0.0253), and significantly higher OATP8 expression (P = 0.0253).Conclusion: Patients with HCCs of high SI ratio in the hepatobiliary phase of gadoxetic acid-enhanced MR imaging can respond better to HAIC.

show abstract

Prognostic factors in patients with advanced hepatocellular carcinoma receiving hepatic arterial infusion chemotherapy

Cited by 63 publications

References 38 publications

Hepatic Arterial Infusion Chemotherapy Using Low-Dose 5-Fluorouracil and Cisplatin for Advanced Hepatocellular Carcinoma

Hepatic Arterial Infusion Chemotherapy Using Low-Dose 5-Fluorouracil and Cisplatin for Advanced Hepatocellular Carcinoma

Tumor and liver determinants of prognosis in unresectable hepatocellular carcinoma: a large case cohort study

Significance of the Signal Intensity of Gadoxetic Acid-enhanced MR Imaging for Predicting the Efficacy of Hepatic Arterial Infusion Chemotherapy in Hepatocellular Carcinoma

Contact Info

Product

Resources

About