Nutritional Index as Prognostic Indicator in Patients Receiving Lenvatinib Treatment for Unresectable Hepatocellular Carcinoma

被引：33

作者：

Hiraoka, Atsushi ^{[1
]}

Kumada, Takashi ^{[2
]}

Tada, Toshifumi ^{[3
]}

Fukunishi, Shinya ^{[4
]}

Atsukawa, Masanori ^{[5
]}

Hirooka, Masashi ^{[6
]}

Tsuji, Kunihiko ^{[7
]}

Ishikawa, Toru ^{[8
]}

Takaguchi, Koichi ^{[9
]}

Kariyama, Kazuya ^{[10
]}

Ltobayashi, Ei ^{[11
]}

Tajiri, Kazuto ^{[12
]}

Shimada, Noritomo ^{[13
]}

Shibata, Hiroshi ^{[14
]}

Ochi, Hironori ^{[15
]}

Kawata, Kazuhito ^{[16
]}

Toyoda, Hidenori ^{[2
]}

Ohama, Hideko ^{[4
]}

Tsutsui, Akemi ^{[9
]}

Itokawa, Norio ^{[5
]}

Hayama, Korenobu ^{[5
]}

Arai, Taeang ^{[5
]}

Imai, Michitaka ^{[8
]}

Nakamura, Shinichiro ^{[3
]}

Michitaka, Kojiro ^{[1
]}

Hiasa, Yoichi ^{[6
]}

Kudo, Masatoshi ^{[17
]}

机构：

[1] Ehime Prefectural Cent Hosp, Gastroenterol Ctr, Kasuga Cho 83, Matsuyama, Ehime 7900024, Japan

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

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

[4] Osaka Med Coll, Dept Gastroenterol, Osaka, Japan

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

[6] Ehime Univ, Dept Gastroenterol & Metabol, Grad Sch Med, Toon, Japan

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

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

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

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

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

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

[13] Otakanomori Hosp, Div Gastroenterol & Hepatol, Kashiwa, Chiba, Japan

[14] Tokushima Prefectural Cent Hosp, Dept Gastroenterol, Tokushima, Japan

[15] Matsuyama Red Cross Hosp, Hepatobiliary Ctr, Matsuyama, Ehime, Japan

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

[17] Kindai Univ, Dept Gastroenterol & Hepatol, Fac Med, Osaka, Japan

来源：

ONCOLOGY | 2020年 / 98卷 / 05期

关键词：

Lenvatinib; Prognostic nutritional index; Modified albumin-bilirubin grade; Prognosis; Hepatocellular carcinoma; CONTRAST-ENHANCED ULTRASONOGRAPHY; ALBUMIN-BILIRUBIN GRADE; SORAFENIB; GUIDELINE; JAPAN;

D O I：

10.1159/000506293

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Background/Aim: Few studies have examined the details of nutritional status in patients with unresectable hepatocellular carcinoma (u-HCC) undergoing systemic chemotherapy with lenvatinib. We evaluated the prognostic/predictive value of nutritional status using Onodera's prognostic nutritional index (O-PNI) for overall survival among patients with u-HCC treated with lenvatinib. Methods: Three-hundred and seventy-five u-HCC patients treated with lenvatinib were enrolled (median age 72 years; Child-Pugh class A/B/C: n = 312/60/3; BCLC stage A/B/C/D: n = 2/159/212/2). We examined median survival time (MST) and time to progression (TTP) in all patients (n = 375), prognosis according to the O-PNI (high/low: >40/<= 40) in 298 patients with lymphocyte findings, and the prognostic/predictive values of Child-Pugh stage, albumin-bilirubin (ALBI)/modified ALBI (mALBI) grade, and O-PNI for Chemotherapy grade (OPNIC grade 1/2/3: O-PNI >40/<= 40 to >36/<= 36). Results: The MST and TTP were 16.6 and 8.0 months, respectively. The MST and TTP according to the O-PNI (>40/<= 40) were "not reached" (NR)/12.4 months (p < 0.001) and 10.0/6.1 months (p = 0.012), respectively. There was a good correlation noted between ALBI score and O-PNI (r = -0.939, p < 0.001). The predictive value of the O-PNI for mALBI grade 2a was 36.0 (specificity/sensitivity = 0.894/0.942; area under the curve [AUC] = 0.978), while that for mALBI grade 1 was 39 (specificity/sensitivity = 0.920/0.929; AUC = 0.972), which was very similar to a high O-PNI. The MST analyzed with the OPNIC in the 298 patients was NR/16.2/10.4 months for OPNIC grade 1/2/3 (p < 0.001), respectively, and the c-index was 0.632, the same as that for mALBI grade (0.632), while that for Child-Pugh class was 0.571. Conclusions: OPNIC grading might have a potential for easy substitution of mALBI grading. A good nutritional status (OPNIC grade 1) or mALBI grade 1 is the best indication for lenvatinib use, while with an OPNIC grade 3, lenvatinib might be not suitable.

引用

页码：295 / 302

页数：8

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