Prognostic score predicting overall survival of patients with intermediate stage of hepatocellular carcinoma after transcatheter transarterial chemoembolization

© JOURNAL OF THE MEDICAL ASSOCIATION OF Thailand 2019 Background: Except benefits, patients with intermediated stage of hepatocellular carcinoma undergoing Transcatheter arterial chemoembolisation (TACE) might be dealt with TACE-related adverse events, especially liver decompensation. The aim of thi...

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Main Authors: S. Jarupongprapa, S. Nimanong, S. Chainuvati, P. Charatcharoenwitthaya, T. Tanwandee, S. Srisajjakul, W. Chotiyaputta
Other Authors: Faculty of Medicine, Siriraj Hospital, Mahidol University
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Published: 2020
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Online Access:https://repository.li.mahidol.ac.th/handle/123456789/52008
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spelling th-mahidol.520082020-01-27T17:16:24Z Prognostic score predicting overall survival of patients with intermediate stage of hepatocellular carcinoma after transcatheter transarterial chemoembolization S. Jarupongprapa S. Nimanong S. Chainuvati P. Charatcharoenwitthaya T. Tanwandee S. Srisajjakul W. Chotiyaputta Faculty of Medicine, Siriraj Hospital, Mahidol University Medicine © JOURNAL OF THE MEDICAL ASSOCIATION OF Thailand 2019 Background: Except benefits, patients with intermediated stage of hepatocellular carcinoma undergoing Transcatheter arterial chemoembolisation (TACE) might be dealt with TACE-related adverse events, especially liver decompensation. The aim of this study is to develop a prognostic score for avoiding unnecessary retreatment with TACE. Materials and Methods: A retrospective cohort study between January 2007 and December 2012 at Siriraj Hospital, Mahidol University including 216 patients with intermediate stage of HCC undergoing consecutive TACE within 90 days. We investigated the effect of baseline characteristics, liver function, and dynamic tumor response after TACE session on the median overall survival. Results: Five independent parameters impacted on overall survival (OS) with statistical significance in multivariate analysis. These factors were baseline Child-Pugh score (CTP) class B (hazard ratio [HR] 1.77, p = 0.04), the Barcelona Clinic Liver Cancer (BCLC) stage B (HR 1.95, p = 0.001), increased CTP score (+1 [HR 2.29], +2 [HR 11.74], p<0.001], baseline AFP level >200 and <50% reduction after TACE (HR 2.07, p = 0.003) as well as radiologic response (HR 1.56, p = 0.01). The new prognostic score was developed and divided into 2 groups (<3 point and >3 point) with different prognosis (median OS 26.3 months vs. 10.7 months, p<0.001). Furthermore, prognostic score of >3 point was associated with higher TACE related liver decompensation with relative risk 20.2 (p<0.001). Conclusion: Patients with prognostic score >3 point prior second TACE had poor prognosis and high rate of major complication. Retreatment with TACE should be avoided. 2020-01-27T10:16:24Z 2020-01-27T10:16:24Z 2019-01-01 Article Journal of the Medical Association of Thailand. Vol.102, No.12 (2019), 100-106 01252208 2-s2.0-85076683847 https://repository.li.mahidol.ac.th/handle/123456789/52008 Mahidol University SCOPUS https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85076683847&origin=inward
institution Mahidol University
building Mahidol University Library
continent Asia
country Thailand
Thailand
content_provider Mahidol University Library
collection Mahidol University Institutional Repository
topic Medicine
spellingShingle Medicine
S. Jarupongprapa
S. Nimanong
S. Chainuvati
P. Charatcharoenwitthaya
T. Tanwandee
S. Srisajjakul
W. Chotiyaputta
Prognostic score predicting overall survival of patients with intermediate stage of hepatocellular carcinoma after transcatheter transarterial chemoembolization
description © JOURNAL OF THE MEDICAL ASSOCIATION OF Thailand 2019 Background: Except benefits, patients with intermediated stage of hepatocellular carcinoma undergoing Transcatheter arterial chemoembolisation (TACE) might be dealt with TACE-related adverse events, especially liver decompensation. The aim of this study is to develop a prognostic score for avoiding unnecessary retreatment with TACE. Materials and Methods: A retrospective cohort study between January 2007 and December 2012 at Siriraj Hospital, Mahidol University including 216 patients with intermediate stage of HCC undergoing consecutive TACE within 90 days. We investigated the effect of baseline characteristics, liver function, and dynamic tumor response after TACE session on the median overall survival. Results: Five independent parameters impacted on overall survival (OS) with statistical significance in multivariate analysis. These factors were baseline Child-Pugh score (CTP) class B (hazard ratio [HR] 1.77, p = 0.04), the Barcelona Clinic Liver Cancer (BCLC) stage B (HR 1.95, p = 0.001), increased CTP score (+1 [HR 2.29], +2 [HR 11.74], p<0.001], baseline AFP level >200 and <50% reduction after TACE (HR 2.07, p = 0.003) as well as radiologic response (HR 1.56, p = 0.01). The new prognostic score was developed and divided into 2 groups (<3 point and >3 point) with different prognosis (median OS 26.3 months vs. 10.7 months, p<0.001). Furthermore, prognostic score of >3 point was associated with higher TACE related liver decompensation with relative risk 20.2 (p<0.001). Conclusion: Patients with prognostic score >3 point prior second TACE had poor prognosis and high rate of major complication. Retreatment with TACE should be avoided.
author2 Faculty of Medicine, Siriraj Hospital, Mahidol University
author_facet Faculty of Medicine, Siriraj Hospital, Mahidol University
S. Jarupongprapa
S. Nimanong
S. Chainuvati
P. Charatcharoenwitthaya
T. Tanwandee
S. Srisajjakul
W. Chotiyaputta
format Article
author S. Jarupongprapa
S. Nimanong
S. Chainuvati
P. Charatcharoenwitthaya
T. Tanwandee
S. Srisajjakul
W. Chotiyaputta
author_sort S. Jarupongprapa
title Prognostic score predicting overall survival of patients with intermediate stage of hepatocellular carcinoma after transcatheter transarterial chemoembolization
title_short Prognostic score predicting overall survival of patients with intermediate stage of hepatocellular carcinoma after transcatheter transarterial chemoembolization
title_full Prognostic score predicting overall survival of patients with intermediate stage of hepatocellular carcinoma after transcatheter transarterial chemoembolization
title_fullStr Prognostic score predicting overall survival of patients with intermediate stage of hepatocellular carcinoma after transcatheter transarterial chemoembolization
title_full_unstemmed Prognostic score predicting overall survival of patients with intermediate stage of hepatocellular carcinoma after transcatheter transarterial chemoembolization
title_sort prognostic score predicting overall survival of patients with intermediate stage of hepatocellular carcinoma after transcatheter transarterial chemoembolization
publishDate 2020
url https://repository.li.mahidol.ac.th/handle/123456789/52008
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