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A differential risk assessment and decision model for Transarterial chemoembolization in hepatocellular carcinoma based on hepatic function

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dc.contributor.authorNam, Joon Yeul-
dc.contributor.authorChoe, A Reum-
dc.contributor.authorSinn, Dong Hyun-
dc.contributor.authorLee, Jeong-Hoon-
dc.contributor.authorKim, Hwi Young-
dc.contributor.authorYu, Su Jong-
dc.contributor.authorKim, Yoon Jun-
dc.contributor.authorYoon, Jung-Hwan-
dc.contributor.authorLee, Jeong Min-
dc.contributor.authorChung, Jin Wook-
dc.contributor.authorChoi, Sun Young-
dc.contributor.authorLee, Jeong Kyong-
dc.contributor.authorBaek, Seung Yon-
dc.contributor.authorLee, Hye Ah-
dc.contributor.authorKim, Tae Hun-
dc.contributor.authorYoo, Kwon-
dc.date.accessioned2020-07-13T06:31:01Z-
dc.date.available2020-07-13T15:31:55Z-
dc.date.issued2020-06-01-
dc.identifier.citationBMC Cancer. 2020 Jun 01;20(1):504ko_KR
dc.identifier.issn1471-2407-
dc.identifier.urihttps://hdl.handle.net/10371/168585-
dc.description.abstractBackground
The decision of transarterial chemoembolization (TACE) initiation and/or repetition remains challenging in patients with unresectable hepatocellular carcinoma (HCC). The aim was to develop a prognostic scoring system to guide TACE initiation/repetition.

Methods
A total of 597 consecutive patients who underwent TACE as their initial treatment for unresectable HCC were included. We derived a prediction model using independent risk factors for overall survival (OS), which was externally validated in an independent cohort (n = 739).


Results
Independent risk factors of OS included Albumin-bilirubin (ALBI) grade, maximal tumor size, alpha-fetoprotein, and tumor response to initial TACE, which were used to develop a scoring system (ASAR). C-index values for OS were 0.733 (95% confidence interval [CI] = 0.570–0.871) in the derivation, 0.700 (95% CI = 0.445–0.905) in the internal validation, and 0.680 (95% CI = 0.652–0.707) in the external validation, respectively. Patients with ASAR< 4 showed significantly longer OS than patients with ASAR≥4 in all three datasets (all P < 0.001). Among Child-Pugh class B patients, a modified model without TACE response, i.e., ASA(R), discriminated OS with a c-index of 0.788 (95% CI, 0.703–0.876) in the derivation, and 0.745 (95% CI, 0.646–0.862) in the internal validation, and 0.670 (95% CI, 0.605–0.725) in the external validation, respectively. Child-Pugh B patients with ASA(R) < 4 showed significantly longer OS than patients with ASA(R) ≥ 4 in all three datasets (all P < 0.001).

Conclusions
ASAR provides refined prognostication for repetition of TACE in patients with unresectable HCC. For Child-Pugh class B patients, a modified model with baseline factors might guide TACE initiation.
ko_KR
dc.language.isoenko_KR
dc.publisherBMCko_KR
dc.titleA differential risk assessment and decision model for Transarterial chemoembolization in hepatocellular carcinoma based on hepatic functionko_KR
dc.typeArticleko_KR
dc.contributor.AlternativeAuthor남준열-
dc.contributor.AlternativeAuthor최아름-
dc.contributor.AlternativeAuthor신동현-
dc.contributor.AlternativeAuthor이정훈-
dc.contributor.AlternativeAuthor김휘영-
dc.contributor.AlternativeAuthor유수종-
dc.contributor.AlternativeAuthor김윤준-
dc.contributor.AlternativeAuthor윤정환-
dc.contributor.AlternativeAuthor이정민-
dc.contributor.AlternativeAuthor정진욱-
dc.contributor.AlternativeAuthor최선영-
dc.contributor.AlternativeAuthor이정경-
dc.contributor.AlternativeAuthor백승연-
dc.contributor.AlternativeAuthor이혜아-
dc.contributor.AlternativeAuthor김태훈-
dc.contributor.AlternativeAuthor유권-
dc.identifier.doi10.1186/s12885-020-06975-2-
dc.citation.journaltitleBMC Cancerko_KR
dc.language.rfc3066en-
dc.rights.holderThe Author(s)-
dc.date.updated2020-06-16T09:31:52Z-
dc.citation.number1ko_KR
dc.citation.startpage504ko_KR
dc.citation.volume20ko_KR
Appears in Collections:
College of Medicine/School of Medicine (의과대학/대학원)Internal Medicine (내과학전공)Journal Papers (저널논문_내과학전공)
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