Nutritional status is associated with prognosis in patients with advanced unresectable hepatocellular carcinoma treated with atezolizumab plus bevacizumab

被引：15

作者：

Tada, Toshifumi ^{[1
,2
]}

Kumada, Takashi ^{[3
]}

Hiraoka, Atsushi ^{[4
]}

Kariyama, Kazuya ^{[5
]}

Tani, Joji ^{[6
]}

Hirooka, Masashi ^{[7
]}

Takaguchi, Koichi ^{[8
]}

Atsukawa, Masanori ^{[9
]}

Fukunishi, Shinya ^{[10
]}

Itobayashi, Ei ^{[11
]}

Tsuji, Kunihiko ^{[12
]}

Tajiri, Kazuto ^{[13
]}

Ochi, Hironori ^{[14
]}

Ishikawa, Toru ^{[15
]}

Yasuda, Satoshi ^{[16
]}

Ogawa, Chikara ^{[17
]}

Toyoda, Hidenori ^{[16
]}

Hatanaka, Takeshi ^{[18
]}

Nishimura, Takashi ^{[1
]}

Kakizaki, Satoru ^{[19
]}

Kawata, Kazuhito ^{[20
]}

Shimada, Noritomo ^{[21
]}

Tada, Fujimasa ^{[4
]}

Nouso, Kazuhiro ^{[5
]}

Tsutsui, Akemi ^{[8
]}

Ohama, Hideko ^{[4
]}

Morishita, Asahiro ^{[6
]}

Nagano, Takuya ^{[8
]}

Itokawa, Norio ^{[9
]}

Okubo, Tomomi ^{[9
]}

Arai, Taeang ^{[9
]}

Kosaka, Hisashi ^{[22
]}

Imai, Michitaka ^{[15
]}

Naganuma, Atsushi ^{[23
]}

Nakamura, Shinichiro ^{[2
]}

Koizumi, Yohei ^{[7
]}

Matono, Tomomitsu ^{[24
]}

Kaibori, Masaki ^{[22
]}

Iijima, Hiroko ^{[1
]}

Hiasa, Yoichi ^{[7
]}

机构：

[1] Hyogo Med Univ, Dept Internal Med, Div Gastroenterol & Hepatol, 1-1 Mukogawa Cho, Nishinomiya, Hyogo 6638501, Japan

[2] Japanese Red Cross Himeji Hosp, Dept Internal Med, Himeji, Hyogo, Japan

[3] Gifu Kyoritsu Univ, Dept Nursing, Gifu, Japan

[4] Ehime Prefectural Cent Hosp, Gastroenterol Ctr, Matsuyama, Ehime, Japan

[5] Okayama City Hosp, Dept Gastroenterol, Okayama, Japan

[6] Kagawa Univ, Dept Gastroenterol & Hepatol, Takamatsu, Kagawa, Japan

[7] Ehime Univ, Grad Sch Med, Dept Gastroenterol & Metabol, Matsuyama, Ehime, Japan

[8] Kagawa Prefectural Cent Hosp, Dept Hepatol, Takamatsu, Kagawa, Japan

[9] Nippon Med Sch, Dept Internal Med, Div Gastroenterol & Hepatol, Tokyo, Japan

[10] Osaka Med & Pharmaceut Univ, Dept Gastroenterol, Osaka, Japan

[11] Asahi Gen Hosp, Dept Gastroenterol, Chiba, Japan

[12] Teine Keijinkai Hosp, Ctr Gastroenterol, Sapporo, Hokkaido, Japan

[13] Toyama Univ Hosp, Dept Gastroenterol, Toyama, Japan

[14] Japanese Red Cross Matsuyama Hosp, Hepatobiliary Ctr, Matsuyama, Ehime, Japan

[15] Saiseikai Niigata Hosp, Dept Gastroenterol, Niigata, Japan

[16] Ogaki Municipal Hosp, Dept Gastroenterol & Hepatol, Gifu, Japan

[17] Japanese Red Cross Takamatsu Hosp, Dept Gastroenterol, Takamatsu, Kagawa, Japan

[18] Gunma Saiseikai Maebashi Hosp, Dept Gastroenterol, Gunma, Japan

[19] Natl Hosp Org Takasaki Gen Med Ctr, Dept Clin Res, Gunma, Japan

[20] Hamamatsu Univ, Sch Med, Dept Hepatol, Shizuoka, Japan

[21] Otakanomori Hosp, Div Gastroenterol & Hepatol, Chiba, Japan

[22] Kansai Med Univ, Dept Surg, Osaka, Japan

[23] Natl Hosp Org Takasaki Gen Med Ctr, Dept Gastroenterol, Gunma, Japan

[24] Himeji St Marys Hosp, Dept Internal Med, Himeji, Hyogo, Japan

来源：

ONCOLOGY | 2023年 / 101卷 / 04期

关键词：

ALBUMIN-BILIRUBIN GRADE; HEPATIC-FUNCTION; IMPACT; INDEX; MANAGEMENT; SORAFENIB; SURVIVAL; OUTCOMES; CANCER; SCORE;

D O I：

10.1159/000527676

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

IntroductionThis study investigated the relationship between nutritional status, as determined by the prognostic nutritional index (PNI), and outcomes in patients with unresectable hepatocellular carcinoma (HCC) treated with atezolizumab plus bevacizumab (Atez/Bev).MethodsThe study analyzed 485 HCC patients treated with Atez/Bev.ResultsThere were 342 patients with a low PNI (<47) and 143 with a high PNI (>= 47). The median follow-up duration was 9.4 (6.0-14.3) months. Multivariate Cox hazards analysis showed that an alpha-fetoprotein level >= 100 ng/mL (hazard ratio (HR), 2.217; 95% confidence interval (CI), 1.588-3.095; p<0.001) and PNI >= 47 (HR, 0.333; 95% CI, 0.212-0.525; p<0.001) were independently associated with overall survival. Multivariate analysis showed that an alpha-fetoprotein level >= 100 ng/mL (HR, 1.690; 95% CI, 1.316-2.170; p<0.001) and PNI >= 47 (HR, 0.696; 95% CI, 0.528-0.918; p=0.010) were independently associated with progression-free survival. Cumulative overall and progression-free survival rates differed significantly by PNI (p<0.001 and p<0.002, respectively). In a subgroup analysis using inverse probability weighting (IPW) adjustment in patients with albumin-bilirubin grade 1 (n=173), univariate Cox hazards analysis showed that a PNI >= 47 (HR, 0.502; 95% CI, 0.260-0.991; p=0.047) was significantly associated with overall survival. Spline curve analysis revealed that a PNI of approximately 34-48 is an appropriate cutoff for predicting good overall and progression-free survival.Discussion/ConclusionThe PNI, a biomarker of nutritional status, can predict prognosis in patients with HCC treated with Atez/Bev, even those who are considered to have a good prognosis due to good liver function.

引用

页码：270 / 281

页数：12

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