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Predictive Factors for Complete Response and Recurrence after Transarterial Chemoembolization in Hepatocellular Carcinoma

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Background/Aims: To investigate the predictive factors for complete response (CR) and recurrence after CR in patients with hepatocellular carcinoma (HCC) treated with transarterial chemoembolization (TACE). Methods: Among 691 newly diagnosed HCC patients, 287 were treated with TACE as a first therapy. We analyzed the predictive factors for CR, recurrence after CR, and overall survival (OS). Results: Eighty-one patients (28.2%) achieved CR after TACE, and recurrence after CR was detected in 35 patients (43.2%). In multivariate analyses, tumor size (≤5 cm) and single nodularity were predictive factors for CR, with hazard ratios (HRs) of 0.35 (p=0.002) and 0.41 (p<0.001), respectively. Elevated serum α-fetoprotein (AFP) (>20 ng/mL) level and multinodularity exhibited significant relationships with recurrence after CR, with HRs of 2.220 (p=0.026) and 3.887 (p<0.001), respectively. Tumor size (>5 cm), multinodularity, elevated serum AFP (>20 ng/mL) level, Child-Turcotte-Pugh score (B and C), and portal vein thrombosis were significant factors for OS. Conclusions: In patients treated with TACE as a first therapy, tumor size (≤5 cm) and single nodularity were predictive factors for CR, and multinodularity and elevated serum AFP (>20 ng/mL) levels were predictive factors for recurrence after CR. These factors were also significant for OS.

Abstract

Background/Aims: To investigate the predictive factors for complete response (CR) and recurrence after CR in patients with hepatocellular carcinoma (HCC) treated with transarterial chemoembolization (TACE). Methods: Among 691 newly diagnosed HCC patients, 287 were treated with TACE as a first therapy. We analyzed the predictive factors for CR, recurrence after CR, and overall survival (OS). Results: Eighty-one patients (28.2%) achieved CR after TACE, and recurrence after CR was detected in 35 patients (43.2%). In multivariate analyses, tumor size (≤5 cm) and single nodularity were predictive factors for CR, with hazard ratios (HRs) of 0.35 (p=0.002) and 0.41 (p<0.001), respectively. Elevated serum α-fetoprotein (AFP) (>20 ng/mL) level and multinodularity exhibited significant relationships with recurrence after CR, with HRs of 2.220 (p=0.026) and 3.887 (p<0.001), respectively. Tumor size (>5 cm), multinodularity, elevated serum AFP (>20 ng/mL) level, Child-Turcotte-Pugh score (B and C), and portal vein thrombosis were significant factors for OS. Conclusions: In patients treated with TACE as a first therapy, tumor size (≤5 cm) and single nodularity were predictive factors for CR, and multinodularity and elevated serum AFP (>20 ng/mL) levels were predictive factors for recurrence after CR. These factors were also significant for OS.

참고문헌 (29)

  1. Ferlay J, "Estimates of worldwide burden of cancer in 2008: GLOBOCAN 2008", Int J Cancer, 127, pp.2893~2917 (2010)
  2. Montalto G, "Epidemiology, risk factors, and natural history of hepatocellular carcinoma", Ann N Y Acad Sci, 963, pp.13~20 (2002)
  3. Scartozzi M, "The role of LDH serum levels in predicting global outcome in HCC patients undergoing TACE: implications for clinical management", PLoS One, 7, pp.e32653~ (2012)
  4. Park W, "Recurrences of hepatocellular carcinoma following complete remission by transarterial chemoembolization or radiofrequency therapy: focused on the recurrence patterns", Hepatol Res, 43, pp.1304~1312 (2013)
  5. Sugioka A, "Postresection prognosis of patients with hepatocellular carcinoma", Surgery, 113, pp.612~618 (1993)
  6. El-Serag HB, "Diagnosis and treatment of hepatocellular carcinoma", Gastroenterology, 134, pp.1752~1763 (2008)
  7. Forner A, "Treatment of hepatocellular carcinoma", Crit Rev Oncol Hematol, 60, pp.89~98 (2006)
  8. Yu SJ, "A concise review of updated guidelines regarding the management of hepatocellular carcinoma around the world: 2010- 2016", Clin Mol Hepatol, 22, pp.7~17 (2016)
  9. Kohles N, "Prognostic relevance of oncological serum biomarkers in liver cancer patients undergoing transarterial chemoembolization therapy", Tumour Biol, 33, pp.33~40 (2012)
  10. Takayasu K, "Prospective cohort study of transarterial chemoembolization for unresectable hepatocellular carcinoma in 8510 patients", Gastroenterology, 131, pp.461~469 (2006)
  11. Cabibbo G, "Predicting survival in patients with hepatocellular carcinoma treated by transarterial chemoembolisation", Aliment Pharmacol Ther, 34, pp.196~204 (2011)
  12. Hsu KF, "Superselective transarterial chemoembolization vs hepatic resection for resectable early-stage hepatocellular carcinoma in patients with Child-Pugh class a liver function", Eur J Radiol, 81, pp.466~471 (2012)
  13. Tateishi R, "Prediction of recurrence of hepatocellular carcinoma after curative ablation using three tumor markers", Hepatology, 44, pp.1518~1527 (2006)
  14. Izumi N, "Risk factors for distant recurrence of hepatocellular carcinoma in the liver after complete coagulation by microwave or radiofrequency ablation", Cancer, 91, pp.949~956
  15. Imamura H, "Risk factors contributing to early and late phase intrahepatic recurrence of hepatocellular carcinoma after hepatectomy", J Hepatol, 38, pp.200~207 (2003)
  16. Nouso K, "Prognostic factors and treatment effects for hepatocellular carcinoma in Child C cirrhosis", Br J Cancer, 98, pp.1161~1165 (2008)
  17. Arimura E, "Local recurrence is an important prognostic factor of hepatocellular carcinoma", World J Gastroenterol, 11, pp.5601~5606 (2005)
  18. Ueno S, "Prognosis of hepatocellular carcinoma associated with Child class B and C cirrhosis in relation to treatment: a multivariate analysis of 411 patients at a single center", J Hepatobiliary Pancreat Surg, 9, pp.469~477 (2002)
  19. Bruix J, "American Association for the Study of Liver Diseases. Management of hepatocellular carcinoma: an update", Hepatology, 53, pp.1020~1022 (2011)
  20. Ueno S, "Prognostic performance of the new classification of primary liver cancer of Japan (4th edition) for patients with hepatocellular carcinoma: a validation analysis", Hepatol Res, 24, pp.395~403 (2002)
  21. Lencioni R, "Modified RECIST (mRECIST) assessment for hepatocellular carcinoma", Semin Liver Dis, 30, pp.52~60 (2010)
  22. Ebied OM, "Evaluation of responses to chemoembolization in patients with unresectable hepatocellular carcinoma", Cancer, 97, pp.1042~1050 (2003)
  23. Golfieri R, "Hepatocellular carcinoma responding to superselective transarterial chemoembolization: an issue of nodule dimension", J Vasc Interv Radiol, 24, pp.509~517 (2013)
  24. Rou WS, "Risk factors and therapeutic results of early local recurrence after transcatheter arterial chemoembolization", World J Gastroenterol, 20, pp.6995~7004 (2014)
  25. Okuda H, "Comparison of clinicopathological features of patients with hepatocellular carcinoma seropositive for alpha-fetoprotein alone and those seropositive for des-gamma-carboxy prothrombin alone", J Gastroenterol Hepatol, 16, pp.1290~1296 (2001)
  26. Veltri A, "Radiofrequency thermal ablation (RFA) after transarterial chemoembolization (TACE) as a combined therapy for unresectable nonearly hepatocellular carcinoma (HCC)", Eur Radiol, 16, pp.661~669 (2006)
  27. Riaz A, "Alpha-fetoprotein response after locoregional therapy for hepatocellular carcinoma: oncologic marker of radiologic response, progression, and survival", J Clin Oncol, 27, pp.5734~5742 (2009)
  28. Evdokimova VN, "AFP-specific CD4+ helper T-cell responses in healthy donors and HCC patients", J Immunother, 30, pp.425~437 (2007)
  29. Matsui O, "Current status of hepatocellular carcinoma treatment in Japan: transarterial chemoembolization", Clin Drug Investig, 32(Suppl 2), pp.3~13 (2012)

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