C-reactive protein to albumin ratio predicts survival in patients with unresectable hepatocellular carcinoma treated with lenvatinib

被引:10
作者
Tada, Toshifumi [1 ]
Kumada, Takashi [2 ]
Hiraoka, Atsushi [3 ]
Hirooka, Masashi [4 ]
Kariyama, Kazuya [5 ]
Tani, Joji [6 ]
Atsukawa, Masanori [7 ]
Takaguchi, Koichi [8 ]
Itobayashi, Ei [9 ]
Fukunishi, Shinya [10 ]
Tsuji, Kunihiko [11 ]
Ishikawa, Toru [12 ]
Tajiri, Kazuto [13 ]
Ochi, Hironori [14 ]
Yasuda, Satoshi [15 ]
Toyoda, Hidenori [15 ]
Hatanaka, Takeshi [16 ]
Kakizaki, Satoru [17 ]
Shimada, Noritomo [18 ]
Kawata, Kazuhito [19 ]
Tanaka, Takaaki [3 ]
Ohama, Hideko [10 ]
Nouso, Kazuhiro [5 ]
Morishita, Asahiro [6 ]
Tsutsui, Akemi [8 ]
Nagano, Takuya [8 ]
Itokawa, Norio [7 ]
Okubo, Tomomi [7 ]
Arai, Taeang [7 ]
Imai, Michitaka [12 ]
Naganuma, Atsushi [20 ]
Aoki, Tomoko [21 ]
Koizumi, Yohei [4 ]
Nakamura, Shinichiro [1 ]
Joko, Kouji [14 ]
Hiasa, Yoichi [4 ]
Kudo, Masatoshi [21 ]
机构
[1] Japanese Red Cross Himeji Hosp, Dept Internal Med, 1-12-1 Shimoteno, Himeji, Hyogo 6708540, Japan
[2] Gifu Kyoritsu Univ, Dept Nursing, Ogaki, Japan
[3] Ehime Prefectural Cent Hosp, Gastroenterol Ctr, Matsuyama, Ehime, Japan
[4] Ehime Univ, Dept Gastroenterol & Metabol, Grad Sch Med, Touon, Ehime, Japan
[5] Okayama City Hosp, Dept Gastroenterol, Okayama, Japan
[6] Kagawa Univ, Dept Gastroenterol & Hepatol, Takamatsu, Kagawa, Japan
[7] Nippon Med Sch, Dept Internal Med, Div Gastroenterol & Hepatol, Tokyo, Japan
[8] Kagawa Prefectural Cent Hosp, Dept Hepatol, Takamatsu, Kagawa, Japan
[9] Asahi Gen Hosp, Dept Gastroenterol, Asahi, Japan
[10] Osaka Med Coll, Dept Gastroenterol, Osaka, Japan
[11] Teine Keijinkai Hosp, Ctr Gastroenterol, Sapporo, Hokkaido, Japan
[12] Saiseikai Niigata Hosp, Dept Gastroenterol, Niigata, Japan
[13] Toyama Univ Hosp, Dept Gastroenterol, Toyama, Japan
[14] Japanese Red Cross Matsuyama Hosp, Hepatobiliary Ctr, Matsuyama, Ehime, Japan
[15] Ogaki Municipal Hosp, Dept Gastroenterol & Hepatol, Ogaki, Japan
[16] Gunma Saiseikai Maebashi Hosp, Dept Gastroenterol, Maebashi, Gumma, Japan
[17] Natl Hosp Org Takasaki Gen Med Ctr, Dept Clin Res, Takasaki, Gumma, Japan
[18] Otakanomori Hosp, Div Gastroenterol & Hepatol, Kashiwa, Chiba, Japan
[19] Hamamatsu Univ Sch Med, Dept Hepatol, Hamamatsu, Shizuoka, Japan
[20] Natl Hosp Org Takasaki Gen Med Ctr, Dept Gastroenterol, Takasaki, Gumma, Japan
[21] Kindai Univ, Dept Gastroenterol & Hepatol, Osaka, Japan
关键词
LONG-TERM OUTCOMES; PROTEIN/ALBUMIN RATIO; CANCER; INFLAMMATION; SCORE; MANAGEMENT; SORAFENIB; SURGERY; IMPACT; INDEX;
D O I
10.1038/s41598-022-12058-y
中图分类号
O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];
学科分类号
07 ; 0710 ; 09 ;
摘要
We investigated the impact of C-reactive protein to albumin ratio (CAR) on predicting outcomes in 522 patients with unresectable hepatocellular carcinoma (HCC) treated with lenvatinib. We determined the optimal CAR cutoff value with time-dependent receiver operating characteristic curve analysis. Additionally, we clarified the relationship between CAR and liver function or HCC progression. Median overall survival was 20.0 (95% confidence interval (CI), 17.2-22.6) months. The optimal CAR cutoff value was determined to be 0.108. Multivariate analysis showed that high CAR (>= 0.108) (hazard ratio (HR), 1.915; 95% CI, 1.495-2.452), Eastern Cooperative Oncology Group performance status >= 1 (HR, 1.429), and alpha-fetoprotein >= 400 ng/mL (HR, 1.604) were independently associated with overall survival. Cumulative overall survival differed significantly between patients with low versus high CAR (p < 0.001). Median progression-free survival was 7.5 (95% CI, 6.7-8.1) months. Multivariate analysis showed that age, CAR >= 0.108 (HR, 1.644; 95% CI, 1.324-2.043), and non-hepatitis B, non-hepatitis C etiology (HR, 0.726) were independently associated with progression-free survival. Cumulative progression-free survival differed significantly between patients with low versus high CAR (p < 0.001). CAR values were significantly higher as Japan Integrated Staging score increased (p < 0.001). In conclusion, CAR can predict outcomes in patients with unresectable HCC treated with lenvatinib.
引用
收藏
页数:10
相关论文
共 39 条
[1]  
[Anonymous], 1989, JPN J SURG, V19, P98
[2]   Management of hepatoceullular carcinoma [J].
Bruix, J ;
Sherman, M .
HEPATOLOGY, 2005, 42 (05) :1208-1236
[3]   Management of Hepatocellular Carcinoma: An Update [J].
Bruix, Jordi ;
Sherman, Morris .
HEPATOLOGY, 2011, 53 (03) :1020-1022
[4]   Efficacy and safety of sorafenib in patients in the Asia-Pacific region with advanced hepatocellular carcinoma: a phase III randomised, double-blind, placebo-controlled trial [J].
Cheng, Ann-Lii ;
Kang, Yoon-Koo ;
Chen, Zhendong ;
Tsao, Chao-Jung ;
Qin, Shukui ;
Kim, Jun Suk ;
Luo, Rongcheng ;
Feng, Jifeng ;
Ye, Shenglong ;
Yang, Tsai-Sheng ;
Xu, Jianming ;
Sun, Yan ;
Liang, Houjie ;
Liu, Jiwei ;
Wang, Jiejun ;
Tak, Won Young ;
Pan, Hongming ;
Burock, Karin ;
Zou, Jessie ;
Voliotis, Dimitris ;
Guan, Zhongzhen .
LANCET ONCOLOGY, 2009, 10 (01) :25-34
[5]   Inflammation-induced cancer: crosstalk between tumours, immune cells and microorganisms [J].
Elinav, Eran ;
Nowarski, Roni ;
Thaiss, Christoph A. ;
Hu, Bo ;
Jin, Chengcheng ;
Flavell, Richard A. .
NATURE REVIEWS CANCER, 2013, 13 (11) :759-771
[6]   Atezolizumab plus Bevacizumab in Unresectable Hepatocellular Carcinoma [J].
Finn, Richard S. ;
Qin, Shukui ;
Ikeda, Masafumi ;
Galle, Peter R. ;
Ducreux, Michel ;
Kim, Tae-You ;
Kudo, Masatoshi ;
Breder, Valeriy ;
Merle, Philippe ;
Kaseb, Ahmed O. ;
Li, Daneng ;
Verret, Wendy ;
Xu, Derek-Zhen ;
Hernandez, Sairy ;
Liu, Juan ;
Huang, Chen ;
Mulla, Sohail ;
Wang, Yulei ;
Lim, Ho Yeong ;
Zhu, Andrew X. ;
Cheng, Ann-Lii .
NEW ENGLAND JOURNAL OF MEDICINE, 2020, 382 (20) :1894-1905
[7]   The C-reactive Protein to Albumin Ratio Predicts Long-Term Outcomes in Patients with Pancreatic Cancer After Pancreatic Resection [J].
Haruki, Koichiro ;
Shiba, Hiroaki ;
Shirai, Yoshihiro ;
Horiuchi, Takashi ;
Iwase, Ryota ;
Fujiwara, Yuki ;
Furukawa, Kenei ;
Misawa, Takeyuki ;
Yanaga, Katsuhiko .
WORLD JOURNAL OF SURGERY, 2016, 40 (09) :2254-2260
[8]   Survival model predictive accuracy and ROC curves [J].
Heagerty, PJ ;
Zheng, YY .
BIOMETRICS, 2005, 61 (01) :92-105
[9]   A systematic review of the association between circulating concentrations of C reactive protein and cancer [J].
Heikkila, Katriina ;
Ebrahim, Shah ;
Lawlor, Debbie A. .
JOURNAL OF EPIDEMIOLOGY AND COMMUNITY HEALTH, 2007, 61 (09) :824-832
[10]   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