6533b828fe1ef96bd12881a5
RESEARCH PRODUCT
Improved prediction of survival by a risk factor-integrated inflammatory score in Sorafenib treated hepatocellular carcinoma
D. ZöllerD. ZöllerHauke LangM.l. SeibMa WörnsPeter R. GalleArndt WeinmannSandra KochMartin F. SprinzlJens U. MarquardtJulia Weinmann-menkesubject
SorafenibOncologymedicine.medical_specialtyHepatologyReceiver operating characteristicProportional hazards modelbusiness.industryArea under the curvemedicine.diseasedigestive system diseases03 medical and health sciences0302 clinical medicine030220 oncology & carcinogenesisInternal medicineHepatocellular carcinomaCohortmedicine030211 gastroenterology & hepatologyRisk factorNeutrophil to lymphocyte ratiobusinessneoplasmsmedicine.drugdescription
Background and aims Inflammation affects progression of hepatocellular carcinoma (HCC). We therefore postulate that systemic inflammatory markers could help to predict prognosis in HCC patients receiving sorafenib therapy. Methods Overall survival (OS) of HCC patients receiving palliative sorafenib treatment was correlated with the neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), C-reactive protein to albumin ratio (CAR), Glasgow prognostic score (GPS) and the modified GPS (mGPS) along with clinicopathological parameters. Predictors of OS were assessed by multivariable Cox regression and receiver operating characteristics and area under the curve (ROC-AUC) analyses. Results Patients receiving sorafenib (n = 120) for advanced HCC (Barcelona Clinic Liver Cancer stage C) were explored by retrospective analysis. Findings were subsequently validated by a second HCC cohort (n = 113) receiving sorafenib at two independent treatment centers. Multivariable assessment across these HCC cohorts confirmed a stable association of CAR (p ≤ 0.001), GPS (p ≤ 0.01) and mGPS (p ≤ 0.004) with OS. This study also identified Eastern Cooperative Oncology Group (ECOG) performance score (p /≤0.37 cut-off, p 2 point cut-off. Conclusions Inflammatory scores obtained before sorafenib treatment initiation are associated with OS in advanced HCC. Their combination with other risk factors improves prediction of 3- and 12-month survival, which could guide treatment decisions in selected patient subgroups.
year | journal | country | edition | language |
---|---|---|---|---|
2017-01-01 | Journal of Hepatology |