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RESEARCH PRODUCT

Prognostic ability of BCLC-B subclassification in patients with hepatocellular carcinoma undergoing transarterial chemoembolization

Marco BiolatoGiulia GallusiMassimo IavaroneGiuseppe CabibboSimona RaccoAdriano De SantisCristina Della CorteMarcello MaidaAdolfo Francesco AttiliAngelo SangiovanniCalogero CammàGiuseppe La TorreAntonio GasbarriniAntonio GriecoAntonio Gasbarrini

subject

MaleTime FactorsSpecialties of internal medicineKaplan-Meier EstimateGastroenterologyChemoembolization; Liver cancer; Radioembolization; Sorafenib; Staging system; Hepatology0302 clinical medicineRisk FactorsMedicineStage (cooking)Aged 80 and overLiver NeoplasmsGeneral MedicineMiddle AgedSorafenibTreatment OutcomeRC581-951Italy030220 oncology & carcinogenesisHepatocellular carcinoma030211 gastroenterology & hepatologyFemaleChemoembolizationLiver cancerLiver cancerCohort studymedicine.drugSorafenibmedicine.medical_specialtyCarcinoma HepatocellularSettore MED/12 - GASTROENTEROLOGIARisk AssessmentDecision Support Techniques03 medical and health sciencesPredictive Value of TestsInternal medicineHumansChemoembolization TherapeuticRadioembolizationAgedNeoplasm StagingProportional Hazards ModelsRetrospective StudiesHepatologybusiness.industryProportional hazards modelRetrospective cohort studymedicine.diseaseStaging systemLog-rank testMultivariate Analysisbusiness

description

Prognostic ability of BCLC-B Subclassification in Patients with Hepatocellular Carcinoma Undergoing Transarterial Chemoembolization Background and aims. A subclassification system for intermediate hepatocellular carcinoma (HCC) was recently proposed to optimize treatment allocation. The aim of this study was to assess the prognostic ability of that substaging proposal. Patients and methods This is a retrospective multicenter cohort study including patients with intermediate HCC treated with transarterial chemoembolization (TACE). Predictors of survival were identified using the Cox proportional regression model. Results 289 Barcelona Clinic Liver Cancer (BCLC) B patients were included. Median overall survival of the whole cohort was 23 months (C.I. 95% 20.2- 25.8). Child A status (H.R. 1.35, C.I. 95% 1.02-1.78) and tumour burden beyond the up-to-seven criterion (H.R. 1.39, C.I. 95% 1.07- 1.80) were independent prognostic factors for overall survival on multivariate analysis. Analysis of the substages showed that median survival was 33.0 months for B1 stage (n = 81), 20.8 months for B2 stage (n = 106), 16.1 months for B3 stage (n = 24), 22.2 months for B4 stage (n = 42) and 15.0 months for quasi-C stage (n = 36). Regarding the discriminatory ability of the substaging proposal, the log rank test showed a significant survival difference for B1vs. B4 (p = 0.003) and B1 vs. Quasi-C (p = 0.039) and a trend for B1 vs. B2 (p = 0.05) and B1 vs. B3 (p = 0.05). Conclusions Apart from substage B1, BCLC-B subclassification does not discriminate perfectly patients treated with TACE. Also some patients in substage B4 can benefit from TACE.

yearjournalcountryeditionlanguage
2018-01-10
10.5604/01.3001.0010.7542http://hdl.handle.net/10807/112309