Trajectories of Serum Alfa-Fetoprotein and Intermediate-Stage Hepatocellular Carcinoma Outcome after Transarterial Chemoembolization: A Longitudinal Multicenter Cohort Study

2021 ◽  
Author(s):  
Linbin Lu ◽  
Lu-Jun Shen ◽  
Zhixian Wu ◽  
Yanhong Shi ◽  
Peifeng Hou ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Cohort Study ◽  
Transarterial Chemoembolization ◽  
Intermediate Stage ◽  
Multicenter Cohort Study ◽  
Multicenter Cohort

scholarly journals Clinical characteristics, treatment, and prognosis of non-B, non-C hepatocellular carcinoma: a large retrospective multicenter cohort study

2014 ◽  
Vol 50 (3) ◽  
pp. 350-360 ◽  
Author(s):  
Ryosuke Tateishi ◽  
Takeshi Okanoue ◽  
Naoto Fujiwara ◽  
Kiwamu Okita ◽  
Kendo Kiyosawa ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Cohort Study ◽  
Clinical Characteristics ◽  
Multicenter Cohort Study ◽  
Multicenter Cohort

scholarly journals Tumor Marker-Based Definition of the Transarterial Chemoembolization-Refractoriness in Intermediate-Stage Hepatocellular Carcinoma: A Multi-Cohort Study

Cancers ◽  
2019 ◽  
Vol 11 (11) ◽  
pp. 1721 ◽  
Author(s):  
Jun Sik Yoon ◽  
Dong Hyun Sinn ◽  
Jeong-Hoon Lee ◽  
Hwi Young Kim ◽  
Cheol-Hyung Lee ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Cohort Study ◽  
Tumor Marker ◽  
Systemic Therapy ◽  
Transarterial Chemoembolization ◽  
External Validation ◽  
Intermediate Stage ◽  
Prognostic Impact ◽  
High Baseline ◽  
Definition Of

Background: For patients with hepatocellular carcinoma (HCC), the definition of refractoriness to transarterial chemoembolization (TACE), which might make them a candidate for systemic therapy, is still controversial. We aimed to derive and validate a tumor marker-based algorithm to define the refractoriness to TACE in patients with intermediate-stage HCC. Methods: This multi-cohort study was comprised of patients who underwent TACE for treatment-naïve intermediate-stage HCC. We derived a prediction model for overall survival (OS) using the pre- and post-TACE model to predict tumor recurrence after living donor liver transplantation (MoRAL) (i.e., MoRAL score = 11×√protein induced by vitamin K absence-II + 2×√alpha-fetoprotein), which was proven to reflect both tumor burden and biologic aggressiveness of HCC in the explant liver, from a training cohort (n = 193). These results were externally validated in both an independent hospital cohort (from two large-volume centers, n = 140) and a Korean National Cancer Registry sample cohort (n = 149). Results: The changes in MoRAL score (ΔMoRAL) after initial TACE was an independent predictor of OS (MoRAL-increase vs. MoRAL-non-increase: adjusted hazard ratio (HR) = 2.18, 95% confidence interval (CI) = 1.37–3.46, p = 0.001; median OS = 18.8 vs. 37.8 months). In a subgroup of patients with a high baseline MoRAL score (≥89.5, 25th percentile and higher), the prognostic impact of ΔMoRAL was more pronounced (MoRAL-increase vs. MoRAL-non-increase: HR = 3.68, 95% CI = 1.54–8.76, p < 0.001; median OS = 9.9 vs. 37.4 months). These results were reproduced in the external validation cohorts. Conclusion: The ΔMoRAL after the first TACE, a simple and objective index, provides refined prognostication for patients with intermediate-stage HCC. Proceeding to a second TACE may not provide additional survival benefits in cases of a MoRAL-increase after the first TACE in patients with a high baseline MoRAL score (≥89.5), who might be candidates for systemic therapy.

THE ITA.LI.CA STAGING SYSTEM FOR PATIENTS WITH HEPATOCELLULAR CARCINOMA: A MULTICENTER COHORT STUDY

2015 ◽  
Vol 47 ◽  
pp. e23
Author(s):  
F. Farinati ◽  
A. Vitale ◽  
F. Trevisani ◽  
T. Huo ◽  
Y.-H. Lee ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Cohort Study ◽  
Staging System ◽  
Multicenter Cohort Study ◽  
Multicenter Cohort
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