Nam Hee Kim1, Taeheon Lee2, Yong Kyun Cho3, Byung Ik Kim3, Hong Joo Kim3. 1. Preventive Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea. 2. Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea. 3. Division of Gastroenterology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
Abstract
BACKGROUND AND AIM: The aim of this study is to determine the impact of clinically evident portal hypertension (CEPH) on prognosis of hepatocellular carcinoma (HCC) patients with Child-Pugh A cirrhosis who underwent transarterial chemoembolization (TACE). METHODS: A retrospective data analysis was performed for a total of 388 treatment-naïve HCC patients with Child-Pugh A cirrhosis who underwent TACE as first-line treatment from January 2000 to June 2014. Cumulative occurrence rate of complete response (CR), progression-free survival (PFS), and overall survival (OS) were compared between patients with CEPH and those without CEPH (esophageal/gastric varices or low platelet count [< 100 000 per mm3 ] associated with splenomegaly). RESULTS: Among 388 patients, 252 (64.9%) had CEPH, while 136 (35.1%) had no evidence of CEPH at the time of HCC diagnosis. Cumulative probability of the occurrence of CR was significantly lower in patients with CEPH than that in patients without CEPH (P < 0.001). Median PFS was significantly shorter in patients with CEPH than that in patients without CEPH (5 vs 31 months, P < 0.001). Five-year OS rate was significantly lower in patients with CEPH than that in patients without CEPH (41.5% vs 77.5%, P < 0.001). Multivariate analysis indicated that the presence of CEPH was the most powerful poor prognostic factor for the occurrence of CR (adjusted hazard ratio [aHR], 0.16; 95% confidence interval [CI], 0.09-0.28; P < 0.001), PFS (aHR, 5.01; 95% CI, 3.08-8.12; P < 0.001), and OS (aHR, 2.95; 95% CI, 1.66-5.23; P < 0.001). CONCLUSIONS: The presence of CEPH should be considered as a major negative prognostic factor for patients with HCC who will undergo TACE.
BACKGROUND AND AIM: The aim of this study is to determine the impact of clinically evident portal hypertension (CEPH) on prognosis of hepatocellular carcinoma (HCC) patients with Child-Pugh A cirrhosis who underwent transarterial chemoembolization (TACE). METHODS: A retrospective data analysis was performed for a total of 388 treatment-naïve HCC patients with Child-Pugh A cirrhosis who underwent TACE as first-line treatment from January 2000 to June 2014. Cumulative occurrence rate of complete response (CR), progression-free survival (PFS), and overall survival (OS) were compared between patients with CEPH and those without CEPH (esophageal/gastric varices or low platelet count [< 100 000 per mm3 ] associated with splenomegaly). RESULTS: Among 388 patients, 252 (64.9%) had CEPH, while 136 (35.1%) had no evidence of CEPH at the time of HCC diagnosis. Cumulative probability of the occurrence of CR was significantly lower in patients with CEPH than that in patients without CEPH (P < 0.001). Median PFS was significantly shorter in patients with CEPH than that in patients without CEPH (5 vs 31 months, P < 0.001). Five-year OS rate was significantly lower in patients with CEPH than that in patients without CEPH (41.5% vs 77.5%, P < 0.001). Multivariate analysis indicated that the presence of CEPH was the most powerful poor prognostic factor for the occurrence of CR (adjusted hazard ratio [aHR], 0.16; 95% confidence interval [CI], 0.09-0.28; P < 0.001), PFS (aHR, 5.01; 95% CI, 3.08-8.12; P < 0.001), and OS (aHR, 2.95; 95% CI, 1.66-5.23; P < 0.001). CONCLUSIONS: The presence of CEPH should be considered as a major negative prognostic factor for patients with HCC who will undergo TACE.
Authors: Bernhard Scheiner; Gregor Ulbrich; Mattias Mandorfer; Thomas Reiberger; Christian Müller; Fredrik Waneck; Michael Trauner; Claus Kölblinger; Arnulf Ferlitsch; Wolfgang Sieghart; Markus Peck-Radosavljevic; Matthias Pinter Journal: United European Gastroenterol J Date: 2019-03-21 Impact factor: 4.623
Authors: Won Sohn; Cheol Bae Ham; Nam Hee Kim; Hong Joo Kim; Yong Kyun Cho; Woo Kyu Jeon; Byung Ik Kim Journal: PLoS One Date: 2020-12-14 Impact factor: 3.240
Authors: Lukas Müller; Felix Hahn; Aline Mähringer-Kunz; Fabian Stoehr; Simon Johannes Gairing; Friedrich Foerster; Arndt Weinmann; Peter Robert Galle; Jens Mittler; Daniel Pinto Dos Santos; Michael Bernhard Pitton; Christoph Düber; Uli Fehrenbach; Timo Alexander Auer; Bernhard Gebauer; Roman Kloeckner Journal: United European Gastroenterol J Date: 2021-12-16 Impact factor: 4.623