OBJECTIVE: We examined early predictors of the outcome in hepatocellular carcinoma (HCC) patients after transarterial chemoembolization (TACE). METHODS: We analyzed 116 patients with unresectable HCC treated with initial TACE. α-Fetoprotein (AFP) or des-γ-carboxy prothrombin (DCP) response was assessed in patients who had baseline AFP levels ≥200 ng/ml or DCP ≥60 mAU/ml; a positive response was defined as a reduction of >50% compared to baseline 1 month after TACE. RESULTS: A baseline AFP level ≥200 ng/ml was associated with a poor overall survival (OS) (29.4 vs. 6.1 months; p <0.0001). AFP response had no significantly prognostic effects on the OS. Conversely, although the baseline DCP did not influence the OS, DCP responders showed a significantly better OS than nonresponders (67.0 vs. 19.8 months, p = 0.020). The baseline AFP (p = 0.004) and initial tumor response evaluated by the modified Response Evaluation Criteria in Solid Tumors (mRECIST) (p = 0.012) were found to be independent predictors of the OS. The combination of the baseline AFP and initial assessment by mRECIST allowed stratification of the OS. CONCLUSIONS: The combination of the baseline AFP level and mRECIST is useful for the early prediction of the OS in HCC patients who underwent TACE.
OBJECTIVE: We examined early predictors of the outcome in hepatocellular carcinoma (HCC) patients after transarterial chemoembolization (TACE). METHODS: We analyzed 116 patients with unresectable HCC treated with initial TACE. α-Fetoprotein (AFP) or des-γ-carboxy prothrombin (DCP) response was assessed in patients who had baseline AFP levels ≥200 ng/ml or DCP ≥60 mAU/ml; a positive response was defined as a reduction of >50% compared to baseline 1 month after TACE. RESULTS: A baseline AFP level ≥200 ng/ml was associated with a poor overall survival (OS) (29.4 vs. 6.1 months; p <0.0001). AFP response had no significantly prognostic effects on the OS. Conversely, although the baseline DCP did not influence the OS, DCP responders showed a significantly better OS than nonresponders (67.0 vs. 19.8 months, p = 0.020). The baseline AFP (p = 0.004) and initial tumor response evaluated by the modified Response Evaluation Criteria in Solid Tumors (mRECIST) (p = 0.012) were found to be independent predictors of the OS. The combination of the baseline AFP and initial assessment by mRECIST allowed stratification of the OS. CONCLUSIONS: The combination of the baseline AFP level and mRECIST is useful for the early prediction of the OS in HCCpatients who underwent TACE.
Authors: Aline Mähringer-Kunz; Arndt Weinmann; Irene Schmidtmann; Sandra Koch; Sebastian Schotten; Daniel Pinto Dos Santos; Michael Bernhard Pitton; Christoph Dueber; Peter Robert Galle; Roman Kloeckner Journal: BMC Cancer Date: 2018-04-27 Impact factor: 4.430
Authors: Gauri Mishra; Anouk Dev; Eldho Paul; Wa Cheung; Jim Koukounaras; Ashu Jhamb; Ben Marginson; Beng Ghee Lim; Paul Simkin; Adina Borsaru; James Burnes; Mark Goodwin; Vivek Ramachandra; Manfred Spanger; John Lubel; Paul Gow; Siddharth Sood; Alexander Thompson; Marno Ryan; Amanda Nicoll; Sally Bell; Ammar Majeed; William Kemp; Stuart K Roberts Journal: BMC Cancer Date: 2020-05-29 Impact factor: 4.430