44 Citations (Scopus)

Abstract

BackgroundTransarterial chemoembolisation (TACE) is first-line treatment in unresectablehepatocellular carcinoma (HCC) and rescue treatment after failure ofradical treatments in early stage HCC. Prognostic tools for HCC usingtime-fixed Cox models may be unreliable in patients treated with TACEbecause time-varying predictors interact.AimTo explore time-dependent variables as survival predictors in patients withHCC receiving TACE as first-line or second-line treatment.MethodsEighty four consecutive patients with HCC (mean age 68; male gender 62%;Child-Pugh class: A n = 73, B n = 11; Barcelona Clinic Liver Cancer class: An = 44, B n = 24, C n = 16) treated with TACE were enrolled. Clinical, laboratoryand radiological follow-up data were collected from the time of firsttreatment. Time-fixed and time-dependent Cox analyses were done.ResultsOverall survival rates were 89.6% (95% CI 82.5–97.2) at 12 months, 58.8%(95% CI 46.2–74.9) at 24, 35.4% (95% CI 22.3–56.1) at 36 and 17.2% (95%CI 7.0–41.7) at 48 months. Performance status (P < 0.001), number of nodules(P < 0.016) and prior therapy (P = 0.017) were the only variablesstrongly linked to survival by time-fixed Cox model. Performance status(P < 0.001), prior therapy (P = 0.005), number of treatments (P = 0.013),complete response after TACE (P = 0.005) and bilirubin level (P < 0.001)were associated with survival using a time-dependent Cox model.ConclusionsSurvival after TACE is influenced most by performance status, completeresponse and bilirubin. Compared with the time-fixed models, a timedependentCox model has the potential to estimate a more precise prognosisin HCC patients treated with TACE.
Original languageEnglish
Pages (from-to)196-204
Number of pages9
JournalALIMENTARY PHARMACOLOGY &amp; THERAPEUTICS SUPPLEMENT
Volume34
Publication statusPublished - 2011

All Science Journal Classification (ASJC) codes

  • Hepatology
  • Gastroenterology
  • Pharmacology (medical)

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