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.
Lingua originaleEnglish
pagine (da-a)196-204
Numero di pagine9
RivistaALIMENTARY PHARMACOLOGY &amp; THERAPEUTICS SUPPLEMENT
Volume34
Stato di pubblicazionePublished - 2011

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Survival
Proportional Hazards Models
Bilirubin
Therapeutics
Liver Neoplasms
Treatment Failure
Survival Rate
Carcinoma

All Science Journal Classification (ASJC) codes

  • Hepatology
  • Gastroenterology
  • Pharmacology (medical)

Cita questo

@article{fc1b1a5606ff4ba6b62bf6496d79b55b,
title = "Predicting survival in patients with hepatocellular carcinomatreated by transarterial chemoembolisation",
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.",
keywords = "HCC, TACE",
author = "Marco Enea and Antonio Craxi and Giuseppe Cabibbo and Calogero Camma' and {Di Marco}, Vito and Giuseppe Brancatelli and Camm{\`a} and Chiara Genco",
year = "2011",
language = "English",
volume = "34",
pages = "196--204",
journal = "ALIMENTARY PHARMACOLOGY &amp; THERAPEUTICS SUPPLEMENT",
issn = "0953-0673",

}

TY - JOUR

T1 - Predicting survival in patients with hepatocellular carcinomatreated by transarterial chemoembolisation

AU - Enea, Marco

AU - Craxi, Antonio

AU - Cabibbo, Giuseppe

AU - Camma', Calogero

AU - Di Marco, Vito

AU - Brancatelli, Giuseppe

AU - Cammà, null

AU - Genco, Chiara

PY - 2011

Y1 - 2011

N2 - 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.

AB - 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.

KW - HCC

KW - TACE

UR - http://hdl.handle.net/10447/60815

M3 - Article

VL - 34

SP - 196

EP - 204

JO - ALIMENTARY PHARMACOLOGY &amp; THERAPEUTICS SUPPLEMENT

JF - ALIMENTARY PHARMACOLOGY &amp; THERAPEUTICS SUPPLEMENT

SN - 0953-0673

ER -