J Cancer 2019; 10(3):665-671. doi:10.7150/jca.28528 This issue
1. Department of Hepatobiliary Oncology, Cancer Centre, Sun Yat-sen University, Guangzhou, China
2. Collaborative Innovation Centre for Cancer Medicine, Cancer Centre, Sun Yat-sen University, Guangzhou, China
3. Sate Key Laboratory of Oncology in South China, Guangzhou, China
4. Department of Radiology, Sun Yat-sen University Cancer Centre, Guangzhou, China
5. Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China
* Conributed equally to this work.
Background & aims: It remains controversial whether patients with advanced-stage hepatocellular carcinoma could be benefit from transarterial chemoembolization (TACE) treatment. The purpose of the present study is to identify predictors of survival following TACE in patients with advanced HCC.
Methods: Overall, 303 patients with Barcelona Clinic Liver Cancer (BCLC) stage C HCC who were first treated with TACE from Sun Yat-sen University Cancer Centre between January 2009 and December 2013 were reviewed and enrolled in this study. We carried out Kaplan-Meier and Cox proportional hazard model analyses of prognostic factors.
Results: The median survival of the whole cohort was 8.4 months. Multivariable Cox regression analyses confirmed that four risk factors, high serum levels of gamma-glutamyl transpeptidase (GGT), C-reactive protein (CRP), alkaline phosphatase (ALP) and presence of portal vein tumour thrombosis (PVTT), were independent prognostic factors for overall survival. The expected median survival among patients with 0-1 and 2-4 risk factors were 18.1 (95% CI: 15.5-20.7) and 6.8 (95% CI: 5.8-7.8) months, respectively. Objective tumor response among patients with 0-1 and 2-4 risk factors were 38.9% and 17.3%, respectively.
Conclusion: We found four risk factors were associated with dismal overall survival for advanced HCC patients: serum GGT level, serum CRP, serum ALP and presence of PVTT. TACE may be recommended for patients with advanced HCC with 0-1 risk factors due to the favourable prognosis.
Keywords: Advanced hepatocellular, Transarterial chemoembolization, Prognosis