Feasibility of dynamic risk assessment for patients with repeated trans-arterial chemoembolization for hepatocellular carcinoma View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2019-04-16

AUTHORS

Yehyun Park, Beom Kyung Kim, Jun Yong Park, Do Young Kim, Sang Hoon Ahn, Kwang-Hyub Han, Jong Eun Yeon, Kwan Soo Byun, Hye Soo Kim, Ji Hoon Kim, Seung Up Kim

ABSTRACT

BackgroundHepatoma arterial-embolization prognostic (HAP) score and its modifications (modified HAP [mHAP] and mHAP-II), consisting of some or all of the following factors of tumor size, number, alpha-fetoprotein, bilirubin, and serum albumin, have been found to predict outcomes after trans-arterial chemoembolization (TACE) for hepatocellular carcinoma (HCC). We investigated the feasibility of using HAP-related risk scores for dynamic risk assessment during repeated TACE.MethodsA total of 619 HCC patients treated with TACE from two institutions between 2003 and 2010 were included.ResultsPatients with A-B class risk scores showed significantly better survival than those with C-D class risk scores at the first (median 43.7 vs. 21.5 months for mHAP-II, 35.2 vs. 10.2 months for mHAP, and 39.8 vs. 18.6 months for HAP; all P < 0.001) and the second rounds of TACE (38.6 vs. 17.2 months for mHAP-II, 30.0 vs. 8.5 months for mHAP, and 32.6 vs. 17.3 months for HAP; all P < 0.001). Sequential assessment of risk scores at the second TACE round was applied for patients with A-B class risk scores at the first TACE round, which further identified two subgroups of A-B and C-D class risk scores with different outcomes (median survival 40.6 vs. 19.6 months for mHAP-II, 31.2 vs. 16.9 months for mHAP, and 35.8 vs. 21.0 months for HAP; all P < 0.001). Compared with mHAP and HAP, mHAP-II showed the highest likelihood ratio (22.61 vs. 14.67 and 13.97, respectively), highest linear trend (24.43 vs. 19.67 and 14.19, respectively), and lowest Akaike information criteria value (1432.51 vs. 3412.29 and 2296.98, respectively).ConclusionsAll HAP-related risk scores dynamically predicted outcomes during repeated TACE. Sequential risk assessment using mHAP-II best identified optimal candidates for repeated TACE. More... »

PAGES

363

Identifiers

URI

http://scigraph.springernature.com/pub.10.1186/s12885-019-5495-6

DOI

http://dx.doi.org/10.1186/s12885-019-5495-6

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1113523928

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/30991968


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26 schema:description BackgroundHepatoma arterial-embolization prognostic (HAP) score and its modifications (modified HAP [mHAP] and mHAP-II), consisting of some or all of the following factors of tumor size, number, alpha-fetoprotein, bilirubin, and serum albumin, have been found to predict outcomes after trans-arterial chemoembolization (TACE) for hepatocellular carcinoma (HCC). We investigated the feasibility of using HAP-related risk scores for dynamic risk assessment during repeated TACE.MethodsA total of 619 HCC patients treated with TACE from two institutions between 2003 and 2010 were included.ResultsPatients with A-B class risk scores showed significantly better survival than those with C-D class risk scores at the first (median 43.7 vs. 21.5 months for mHAP-II, 35.2 vs. 10.2 months for mHAP, and 39.8 vs. 18.6 months for HAP; all P < 0.001) and the second rounds of TACE (38.6 vs. 17.2 months for mHAP-II, 30.0 vs. 8.5 months for mHAP, and 32.6 vs. 17.3 months for HAP; all P < 0.001). Sequential assessment of risk scores at the second TACE round was applied for patients with A-B class risk scores at the first TACE round, which further identified two subgroups of A-B and C-D class risk scores with different outcomes (median survival 40.6 vs. 19.6 months for mHAP-II, 31.2 vs. 16.9 months for mHAP, and 35.8 vs. 21.0 months for HAP; all P < 0.001). Compared with mHAP and HAP, mHAP-II showed the highest likelihood ratio (22.61 vs. 14.67 and 13.97, respectively), highest linear trend (24.43 vs. 19.67 and 14.19, respectively), and lowest Akaike information criteria value (1432.51 vs. 3412.29 and 2296.98, respectively).ConclusionsAll HAP-related risk scores dynamically predicted outcomes during repeated TACE. Sequential risk assessment using mHAP-II best identified optimal candidates for repeated TACE.
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33 schema:keywords HAp
34 HCC patients
35 MHAP
36 ResultsPatients
37 albumin
38 alpha-fetoprotein
39 assessment
40 better survival
41 bilirubin
42 candidates
43 carcinoma
44 chemoembolization
45 criterion values
46 different outcomes
47 dynamic risk assessment
48 factors
49 feasibility
50 hepatocellular carcinoma
51 higher linear trend
52 highest likelihood ratio
53 information criterion values
54 institutions
55 likelihood ratio
56 linear trend
57 mHAP-II
58 modification
59 number
60 optimal candidates
61 outcomes
62 patients
63 prognostic score
64 ratio
65 risk assessment
66 risk score
67 rounds
68 scores
69 second round
70 sequential assessment
71 sequential risk assessment
72 serum albumin
73 size
74 subgroups
75 survival
76 total
77 trans-arterial chemoembolization
78 trends
79 tumor size
80 values
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