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Comprehensive predictive factors for CalliSpheres® microspheres (CSM) drug-eluting bead-transarterial chemoembolization and conventional transarterial chemoembolization on treatment response and survival in hepatocellular carcinoma patients - 03/02/21

Doi : 10.1016/j.clinre.2020.05.008 
Changyong Chen a, 1, Huaiming Qiu b, 1, , Yuanhui Yao c, Zishu Zhang d, Cong Ma d, Yilong Ma e, Chang Zhao e, Hua Xiang c, Hui Zhao f, Chuansheng Zheng g, Bin Xiong g, Haiping Li a, Qingyun Long h, Jun Zhou h, Chao Luo b, Hongyao Hu f,
a Department of Radiology, Xiangya Hospital Central South University, Changsha, China 
b Department of Radiology, Wuhan General Hospita of Guangzhou Military, 627 Wuluo Road, Wuhan 430070, China 
c Department of Intervention, Hunan Provincial People's Hospital, Changsha, China 
d Department of Radiology, The Second Xiangya Hospital of Central South University, Changsha, China 
e Department of Interventional Therapy, Guangxi Medical University Affiliated Tumor Hospital, Nanning, China 
f Department of Interventional Radiology,Department of Radiology, Renmin Hospital of Wuhan University, Jiefang Road 238, Wuhan 430060, China 
g Department of Interventional Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China 
h Department of Radiology, Zhongnan Hospital of Wuhan University, Wuhan, China 

Corresponding authors.
Sous presse. Épreuves corrigées par l'auteur. Disponible en ligne depuis le Wednesday 03 February 2021
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Highlights

In total patients, history of drink and largest nodule size7cm could independently predict worse ORR, and DEB-TACE predicted better OS, while largest nodule size7cm, Child-Pugh stage (B/C vs. A), ALB abnormal, ALP abnormal or AFP abnormal predicted worse survival.
In DEB-TACE group, previous cTACE and ANC abnormal were independent factors predicting worse ORR, and hepatic vein invasion, Child-Pugh stage (B/C vs. A) or AFP abnormal could independently predict poor survival.
In cTACE group, largest nodule size7cm was an independent risk factor for predicting ORR, and multifocal disease as well as ALB abnormal predicted poor OS.

Le texte complet de cet article est disponible en PDF.

Summary

Background

Transarterial chemoembolization (TACE) is widely applied in hepatocellular carcinoma (HCC) patients who are not suitable for surgical treatment. We aimed to investigate the treatment outcomes and comprehensive prognostic factors of CalliSpheres® microspheres (CSM) drug-eluting bead TACE (DEB-TACE) treatment and conventional TACE (cTACE) treatment in HCC patients.

Methods

Three hundred and thirty-five HCC patients received DEB-TACE or cTACE treatment were consecutively enrolled in multi-center, retrospective cohort study. Treatment response was conducted at M1, M3 or M6 after treatment. Progression free survival (PFS) and overall survival (OS) were recorded. Thirty-seven baseline factors including demographic characteristics, clinical features, biochemical indexes and previous treatment histories were selected.

Results

In total patients, history of drink and largest nodule size7cm independently predicted worse ORR, DEB-TACE predicted better OS, while largest nodule size7cm, increased Child-Pugh stage, ALB abnormal, ALP abnormal or AFP abnormal predicted worse survival. For DEB-TACE group, previous cTACE and ANC abnormal independently predicted worse ORR, and hepatic vein invasion, increased Child-Pugh stage or AFP abnormal independently predicted poor survival. For cTACE group, largest nodule size7cm independently predicted poor ORR, and multifocal disease as well as ALB abnormal predicted poor OS.

Conclusions

History of drink, largest nodule size7cm, DEB-TACE, increased Child-Pugh stage, abnormal ALB, ALP or AFP are potential prognostic factors in total patients, previous cTACE and ANC abnormal, hepatic vein invasion, increased Child-Pugh stage or AFP abnormal are potential prognostic factors in DEB-TA group, and largest nodule size7cm, multifocal disease and ALB abnormal are potential prognostic factors in cTACE group.

Le texte complet de cet article est disponible en PDF.

Keywords : Prognostic factors, Drug-eluting bead-transarterial chemoembolization, Conventional transarterial chemoembolization, Treatment response, Survival, Hepatocellular carcinoma

Abbreviations : HCC, CR, TACE, cTACE, DEB-TACE, CSM, HB, HC, ECOG, BCLC, WBC, RBC, ANC, Hb, PLT, ALB, TP, TBIL, TBA, ALT, AST, ALP, BCr, BUN, AFP, CEA, CA199, RT, DSA, CT, MRI, EPO, PVA, IV, M1, Mrecist, CR, PR, SD, PD, ORR, DCR, PFS, OS, RCT


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