Predictors of Immediate Deterioration of the Child-Pugh Classification From A to B After Transcatheter Arterial Chemo-Embolization for Treatment-Naive Hepatocellular Carcinoma

被引:2
作者
Asano, Kazuo [1 ]
Kageyama, Ken [2 ]
Yamamoto, Akira [2 ]
Jogo, Atsushi [2 ]
Nakano, Mariko [2 ]
Murai, Kazuki [2 ]
Yukawa-Muto, Yoshimi [3 ]
Odagiri, Naoshi [3 ]
Kotani, Kohei [3 ]
Kozuka, Ritsuzo [3 ]
Kawamura, Etsushi [3 ]
Fujii, Hideki [3 ]
Uchida-Kobayashi, Sawako [4 ]
Enomoto, Masaru [3 ]
Kawada, Norifumi [3 ]
Miki, Yukio [2 ]
机构
[1] Osaka City Univ, Grad Sch Med, Dept Diagnost & Intervent Radiol, Osaka, Japan
[2] Osaka Metropolitan Univ, Grad Sch Med, Dept Diagnost & Intervent Radiol, Osaka, Japan
[3] Osaka Metropolitan Univ, Grad Sch Med, Dept Hepatol, Osaka, Japan
[4] Osaka Metropolitan Univ, Grad Sch Med, Dept Premier Prevent Med, Osaka, Japan
关键词
Child-Pugh classification; hepatocellular carcinoma; preserved liver function; transcatheter arterial chemoembolization; TRANSARTERIAL CHEMOEMBOLIZATION; LIVER-FUNCTION; SORAFENIB; LENVATINIB; EFFICACY; SAFETY;
D O I
10.1002/cam4.70367
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
AimThe purpose of this study was to evaluate the predictors of deterioration of the Child-Pugh classification 1 month after transcatheter arterial chemo-embolization (TACE) in patients with treatment-naive hepatocellular carcinoma (HCC).MethodsBetween 2010 and 2020, consecutive patients who underwent conventional TACE using epirubicin as the initial treatment were enrolled. Patients with Barcelona Clinic Liver Cancer stage-0, A or B and Child-Pugh class A were included. The Child-Pugh score was evaluated before treatment and 1 month after TACE. The following variables were analyzed by univariate and multivariate analyses as predictors of deterioration of the Child-Pugh class from A to B: age, sex, etiology, serum albumin, bilirubin, prothrombin time (PT), encephalopathy, ascites, largest tumor diameter, tumor number, tumor location, alpha-fetoprotein, protein induced by vitamin K absence or antagonist-II, epirubicin dosage, ethiodized oil dosage, and number of treated liver segments.ResultsA total of 152 patients were retrospectively enrolled. The deterioration rate of the Child-Pugh class from A to B was 8.6%. Multivariable analysis showed that serum albumin <= 3.8 g/dL, PT <= 80%, and largest tumor diameter >= 3.8 cm were predictors of deterioration of the Child-Pugh class. The deterioration rate to Child-Pugh class B was 0% in patients with up to one of these factors, 14.3% in those with two factors, and 70% in those with three factors.ConclusionsA combination of serum albumin <= 3.8 g/dL, PT <= 80%, and largest tumor diameter >= 3.8 cm can predict the immediate deterioration of the Child-Pugh classification from A to B following TACE.
引用
收藏
页数:10
相关论文
共 32 条
[1]  
Abou-Alfa GK, 2022, NEJM EVID, V1, DOI [10.1056/evidoa2100070, 10.1056/EVIDoa2100070]
[2]   Effectiveness of Sorafenib in Patients with Transcatheter Arterial Chemoembolization (TACE) Refractory and Intermediate-Stage Hepatocellular Carcinoma [J].
Arizumi, Tadaaki ;
Ueshima, Kazuomi ;
Minami, Tomohiro ;
Kono, Masashi ;
Chishina, Hirokazu ;
Takita, Masahiro ;
Kitai, Satoshi ;
Inoue, Tatsuo ;
Yada, Norihisa ;
Hagiwara, Satoru ;
Minami, Yasunori ;
Sakurai, Toshiharu ;
Nishida, Naoshi ;
Kudo, Masatoshi .
LIVER CANCER, 2015, 4 (04) :253-262
[3]   TACE for treatment-naive HCC has different treatment effects depending on central or peripheral tumor-location [J].
Asano, Kazuo ;
Kageyama, Ken ;
Yamamoto, Akira ;
Jogo, Atsushi ;
Uchida-Kobayashi, Sawako ;
Sohgawa, Etsuji ;
Murai, Kazuki ;
Kawada, Norifumi ;
Miki, Yukio .
LIVER CANCER, 2023, 12 (06) :576-589
[4]  
European Assoc Study Liver, 2018, J HEPATOL, V69, P182, DOI 10.1016/j.jhep.2018.03.019
[5]   IMbrave150: Updated overall survival (OS) data from a global, randomized, open-label phase III study of atezolizumab (atezo) plus bevacizumab (bev) versus sorafenib (sor) in patients (pts) with unresectable hepatocellular carcinoma (HCC). [J].
Finn, Richard S. ;
Qin Shukui ;
Ikeda, Masafumi ;
Galle, Peter R. ;
Ducreux, Michel ;
Kim, Tae-You ;
Lim, Ho Yeong ;
Kudo, Masatoshi ;
Breder, Valeriy Vladimirovich ;
Merle, Philippe ;
Kaseb, Ahmed Omar ;
Li Daneng ;
Verret, Wendy ;
Shao Hui ;
Liu Juan ;
Li Lindong ;
Zhu, Andrew X. ;
Chen, Ann-Lii .
JOURNAL OF CLINICAL ONCOLOGY, 2021, 39 (03)
[6]   AASLD guidelines for the treatment of hepatocellular carcinoma [J].
Heimbach, Julie K. ;
Kulik, Laura M. ;
Finn, Richard S. ;
Sirlin, Claude B. ;
Abecassis, Michael M. ;
Roberts, Lewis R. ;
Zhu, Andrew X. ;
Murad, M. Hassan ;
Marrero, Jorge A. .
HEPATOLOGY, 2018, 67 (01) :358-380
[7]   Hepatic Function during Repeated TACE Procedures and Prognosis after Introducing Sorafenib in Patients with Unresectable Hepatocellular Carcinoma: Multicenter Analysis [J].
Hiraoka, Atsushi ;
Kumada, Takashi ;
Kudo, Masatoshi ;
Hirooka, Masashi ;
Koizumi, Yohei ;
Hiasa, Yoichi ;
Tajiri, Kazuto ;
Toyoda, Hidenori ;
Tada, Toshifumi ;
Ochi, Hironori ;
Joko, Koji ;
Shimada, Noritomo ;
Deguchi, Akihiro ;
Ishikawa, Toru ;
Imai, Michitaka ;
Tsuji, Kunihiko ;
Michitaka, Kojiro .
DIGESTIVE DISEASES, 2017, 35 (06) :602-610
[8]   Chemoembolization for Single Large Hepatocellular Carcinoma with Preserved Liver Function: Analysis of Factors Predicting Clinical Outcomes in a 302 Patient Cohort [J].
Kim, Gun Ha ;
Kim, Jin Hyoung ;
Shim, Ju Hyun ;
Ko, Heung-Kyu ;
Chu, Hee Ho ;
Shin, Ji Hoon ;
Yoon, Hyun-Ki ;
Ko, Gi-Young ;
Gwon, Dong Il .
LIFE-BASEL, 2021, 11 (08)
[9]   Predictors of hepatic decompensation after TACE for hepatocellular carcinoma [J].
Kohla, Mohamed A. S. ;
Abu Zeid, Mai I. ;
Al-Warraky, Mohamed ;
Taha, Hossam ;
Gish, Robert G. .
BMJ OPEN GASTROENTEROLOGY, 2015, 2 (01)
[10]   A Novel Treatment Strategy for Patients with Intermediate-Stage HCC Who Are Not Suitable for TACE: Upfront Systemic Therapy Followed by Curative Conversion [J].
Kudo, Masatoshi .
LIVER CANCER, 2021, 10 (06) :539-544