期刊
INVESTIGATIONAL NEW DRUGS
卷 40, 期 5, 页码 1146-1152出版社
SPRINGER
DOI: 10.1007/s10637-022-01261-3
关键词
Downstaging; Hepatocellular carcinoma; Transarterial chemoembolization
资金
- National Natural Science Foundation of China [81803019]
The aim of this study was to identify predictors of successful downstaging of unresectable hepatocellular carcinoma (HCC) outside Milan criteria (MC) by transarterial chemoembolization (TACE). The study found that the number and size of tumors, portal vein tumor thrombosis, hepatitis B surface antigen, and alpha-fetoprotein are significant predictors of successful downstaging of unresectable HCC in patients treated with TACE outside the MC.
Patients with hepatocellular carcinoma (HCC) outside Milan criteria (MC) may be candidates for curative therapy after successful downstaging. We aimed to identify the predictors of successful downstaging of unresectable HCC in patient by transarterial chemoembolization (TACE) outside MC. We performed a retrospective study on patients with unresectable HCC outside MC who received downstaging with TACE. Clinical and laboratory variables were recorded. We identified 101 patients with unresectable HCC who underwent initial TACE, who formed the derivation set of this study. Thirty patients who treated by TACE with the same selection criteria served as an external validation set. We performed univariate and multivariate logistic regression analyses to identify variables associated with successful downstaging. Then we did the predictive model to predict the efficiency of TACE. Of the 101 patients in the study, 26 patients (25.7%) were successfully downstaging and 75 patients (74.3%) failed downstaging. Multivariate analysis of factors to predict successful downstaging of HCC outside MC the number of tumor (P = 0.01), portal vein tumor thrombosis (PVTT)(p < 0.01), the size of tumor (P = 0.02), hepatitis B surface antigen (HBsAg) (P = 0.01), alpha-fetoprotein (AFP) (P = 0.02) as significant predictors of successful downstaging. Then we constructed the predictive model. The area under the ROC curve (AUROC) of the predictive equation was 0.90 (95% confidence interval, 0.83-0.95). We found in our study that the number and size of tumors, PVTT, HBsAg, and AFP are good predictors of successful downstaging of unresectable HCC in patients by TACE outside the MC.
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