K J Paprottka1, F Schoeppe2, M Ingrisch2, J Rübenthaler2, N N Sommer2, E De Toni3, H Ilhan4, M Zacherl4, A Todica4, P M Paprottka2. 1. Department of Clinical Radiology, LMU - University of Munich, Marchioninistrasse. 15, 81377, Munich, Germany. karolin.paprottka@med.lmu.de. 2. Department of Clinical Radiology, LMU - University of Munich, Marchioninistrasse. 15, 81377, Munich, Germany. 3. Department of Hepatology, LMU - University of Munich, Munich, Germany. 4. Department of Nuclear Medicine, LMU - University of Munich, Munich, Germany.
Abstract
PURPOSE: To determine pre-therapeutic predictive factors for overall survival (OS) after yttrium (Y)-90 radioembolization (RE). METHODS: We retrospectively analyzed the pre-therapeutic characteristics (sex, age, tumor entity, hepatic tumor burden, extrahepatic disease [EHD] and liver function [with focus on bilirubin and cholinesterase level]) of 389 consecutive patients with various refractory liver-dominant tumors (hepatocellular carcinoma [HCC], cholangiocarcinoma [CCC], neuroendocrine tumor [NET], colorectal cancer [CRC] and metastatic breast cancer [MBC]), who received Y-90 radioembolization for predicting survival. Predictive factors were selected by univariate Cox regression analysis and subsequently tested by multivariate analysis for predicting patient survival. RESULTS: The median OS was 356 days (95% CI 285-427 days). Stable disease was observed in 132 patients, an objective response in 71 (one of which was complete remission) and progressive disease in 122. The best survival rate was observed in patients with NET, and the worst in patients with MBC. In the univariate analyses, extrahepatic disease (P < 0.001), large tumor burden (P = 0.001), high bilirubin levels (>1.9 mg/dL, P < 0.001) and low cholinesterase levels (CHE <4.62 U/I, P < 0.001) at baseline were significantly associated with poor survival. Tumor entity, tumor burden, extrahepatic disease and CHE were confirmed in the multivariate analysis as independent predictors of survival. Sex, applied RE dose and age had no significant influence on OS. CONCLUSIONS: Pre-therapeutic baseline bilirubin and CHE levels, extrahepatic disease and hepatic tumor burden are associated with patient survival after RE. Such parameters may be used to improve patient selection for RE of primary or metastatic liver tumors.
PURPOSE: To determine pre-therapeutic predictive factors for overall survival (OS) after yttrium (Y)-90 radioembolization (RE). METHODS: We retrospectively analyzed the pre-therapeutic characteristics (sex, age, tumor entity, hepatic tumor burden, extrahepatic disease [EHD] and liver function [with focus on bilirubin and cholinesterase level]) of 389 consecutive patients with various refractory liver-dominant tumors (hepatocellular carcinoma [HCC], cholangiocarcinoma [CCC], neuroendocrine tumor [NET], colorectal cancer [CRC] and metastatic breast cancer [MBC]), who received Y-90 radioembolization for predicting survival. Predictive factors were selected by univariate Cox regression analysis and subsequently tested by multivariate analysis for predicting patient survival. RESULTS: The median OS was 356 days (95% CI 285-427 days). Stable disease was observed in 132 patients, an objective response in 71 (one of which was complete remission) and progressive disease in 122. The best survival rate was observed in patients with NET, and the worst in patients with MBC. In the univariate analyses, extrahepatic disease (P < 0.001), large tumor burden (P = 0.001), high bilirubin levels (>1.9 mg/dL, P < 0.001) and low cholinesterase levels (CHE <4.62 U/I, P < 0.001) at baseline were significantly associated with poor survival. Tumor entity, tumor burden, extrahepatic disease and CHE were confirmed in the multivariate analysis as independent predictors of survival. Sex, applied RE dose and age had no significant influence on OS. CONCLUSIONS: Pre-therapeutic baseline bilirubin and CHE levels, extrahepatic disease and hepatic tumor burden are associated with patient survival after RE. Such parameters may be used to improve patient selection for RE of primary or metastatic liver tumors.
Authors: T F Jakobs; K J Paprottka; F Raeßler; F Strobl; S Lehner; H Ilhan; C G Trumm; W P Fendler; W Sommer; P M Paprottka Journal: Eur Radiol Date: 2016-04-08 Impact factor: 5.315
Authors: Bruno Sangro; Livio Carpanese; Roberto Cianni; Rita Golfieri; Daniele Gasparini; Samer Ezziddin; Philipp M Paprottka; Francesco Fiore; Mark Van Buskirk; Jose Ignacio Bilbao; Giuseppe Maria Ettorre; Rita Salvatori; Emanuela Giampalma; Onelio Geatti; Kai Wilhelm; Ralf Thorsten Hoffmann; Francesco Izzo; Mercedes Iñarrairaegui; Carlo Ludovico Maini; Carlo Urigo; Alberta Cappelli; Alessandro Vit; Hojjat Ahmadzadehfar; Tobias Franz Jakobs; Secondo Lastoria Journal: Hepatology Date: 2011-06-30 Impact factor: 17.425
Authors: Iswanto Sucandy; Susannah Cheek; Benjamin J Golas; Allan Tsung; David A Geller; James W Marsh Journal: HPB (Oxford) Date: 2016-07-09 Impact factor: 3.647
Authors: Philipp M Paprottka; Ralf-T Hoffmann; Alexander Haug; Wieland H Sommer; Franziska Raessler; Christoph G Trumm; Gerwin P Schmidt; Nima Ashoori; Maximilian F Reiser; Tobias F Jakobs Journal: Cardiovasc Intervent Radiol Date: 2011-08-17 Impact factor: 2.740
Authors: Andrew S Kennedy; William A Dezarn; Patrick McNeillie; Doug Coldwell; Charles Nutting; Dennis Carter; Ravi Murthy; Steven Rose; Richard R P Warner; David Liu; Holger Palmedo; Carroll Overton; Bonita Jones; Riad Salem Journal: Am J Clin Oncol Date: 2008-06 Impact factor: 2.339
Authors: Ricarda Rühl; Max Seidensticker; Nils Peters; Konrad Mohnike; Jan Bornschein; Kerstin Schütte; Holger Amthauer; Peter Malfertheiner; Maciej Pech; Jens Ricke Journal: Dig Dis Date: 2009-06-22 Impact factor: 2.404
Authors: Robert Damm; Ricarda Seidensticker; Gerhard Ulrich; Leonie Breier; Ingo G Steffen; Max Seidensticker; Benjamin Garlipp; Konrad Mohnike; Maciej Pech; Holger Amthauer; Jens Ricke Journal: BMC Cancer Date: 2016-07-20 Impact factor: 4.430
Authors: Rehan Ali; Ahsun Riaz; Ahmed Gabr; Nadine Abouchaleh; Ronald Mora; Ali Al Asadi; Juan Carlos Caicedo; Michael Abecassis; Nitin Katariya; Haripriya Maddur; Laura Kulik; Robert J Lewandowski; Riad Salem Journal: Eur J Nucl Med Mol Imaging Date: 2017-08-15 Impact factor: 9.236
Authors: Rucha M Shah; Sarah Sheikh; Jimmy Shah; Elaina Vivian; Alejandro Mejia; Islam Shahin; Parvez S Mantry Journal: J Gastrointest Oncol Date: 2021-08
Authors: Max Masthoff; Philipp Schindler; Fabian Harders; Walter Heindel; Christian Wilms; Hartmut H Schmidt; Andreas Pascher; Lars Stegger; Kambiz Rahbar; Moritz Wildgruber; Michael Köhler Journal: Ann Transl Med Date: 2020-09
Authors: Alexandra Gangi; Jehan Shah; Nathan Hatfield; Johnna Smith; Jennifer Sweeney; Junsung Choi; Ghassan El-Haddad; Benjamin Biebel; Nainesh Parikh; Bulent Arslan; Sarah E Hoffe; Jessica M Frakes; Gregory M Springett; Daniel A Anaya; Mokenge Malafa; Dung-Tsa Chen; Yunyun Chen; Richard D Kim; Ravi Shridhar; Bela Kis Journal: J Vasc Interv Radiol Date: 2018-07-02 Impact factor: 3.464
Authors: Fourat Ridouani; Mohamed M Soliman; Ryan W England; Meier Hsu; Chaya S Moskowitz; Raphael Doustaly; Constantinos T Sofocleous; F Edward Boas; Hooman Yarmohammadi; Amy R Deipolyi Journal: Eur J Radiol Date: 2021-01-12 Impact factor: 3.528