Prognosis Nomogram for Hepatocellular Carcinoma Patients with Portal Vein Invasion Undergoing Transarterial Chemoembolization Plus Sorafenib Treatment: A Retrospective Multicentre Study
Prognosis Nomogram for Hepatocellular Carcinoma Patients with Portal Vein Invasion Undergoing Transarterial Chemoembolization Plus Sorafenib Treatment: A Retrospective Multicentre Study
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接受经动脉化疗栓塞加索拉非尼治疗的肝细胞癌门静脉侵犯患者的预后列线图：一项回顾性多中心研究
DOI：
10.1007/s00270-020-02579-2
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发表时间：
2020-09
期刊：
影响因子：
--
通讯作者：
Ni Cai Fang
中科院分区：
文献类型：
--
作者：
Zhang Lei;Sun Jun Hui;Hou Zhong Heng;Zhong Bin Yan;Yang Min Jie;Zhou Guan Hui;Wang Wan Sheng;Huang Peng;Zhang Shen;Li Zhi;Zhu Xiao Li;Yan Zhi Ping;Ni Cai Fang
目的探讨索拉非尼联合肝动脉化疗栓塞术（TACE）治疗肝细胞癌（HCC）伴门静脉癌栓（PVTT）的疗效，并建立预后预测诺模图，以区分目标患者和分层风险。回顾性研究包括185例连续治疗，2012年1月1日至2017年12月31日期间，三家机构接受TACE联合索拉非尼治疗的HCC和PVTT初治患者。该研究的主要结局指标是总生存期（OS）。PVTT的类型由日本肝癌研究组分类。结果Vp 1 -3组和Vp 4组的中位OS为12.4个月，（11.7-18.9）和8.5个月（7.6-11.2）（P= 0.00098），Vp 1 -2和Vp 3亚组的中位OS差异有统计学意义（16.4个月（12.2-27.9）vs. 10.9个月（8.4-18.1），P= 0.041）。多因素考克斯回归分析显示肿瘤大小、白蛋白-胆红素分级和PVTT类型是独立的预后因素。结论TACE联合索拉非尼治疗晚期肝癌伴节段或亚节段PVTT患者的生存率明显高于伴主要PVTT患者。该列线图可用于识别晚期肝癌伴PVTT患者中可能从联合治疗中获益最多的患者，并有助于临床实践中的决策。
ObjectivesTo explore the outcomes of combined transarterial chemoembolization (TACE) with sorafenib in hepatocellular carcinoma (HCC) patients with portal vein tumour thrombus (PVTT) and to establish a prognostic prediction nomogram to differentiate target patients and stratify risk.Materials and MethodsThis multicentre, retrospective study consisted of 185 consecutive treatment-naïve patients with HCC and PVTT treated with TACE plus sorafenib from three institutions between January 1st, 2012 and December 31st, 2017. The primary outcome measurement of the study was overall survival (OS). The type of PVTT was classified by the Liver Cancer Study Group of Japan. The prognostic nomogram was established based on the predictors and was performed with interval validation.ResultsThe median OS of the Vp1-3 and Vp4 groups was 12.4 months (11.7–18.9) and 8.5 months (7.6–11.2) (P= 0.00098), respectively, and there was a significant difference in the median OS between the Vp1-2 and Vp3 subgroups (16.4 months (12.2–27.9) vs. 10.9 months (8.4–18.1),P= 0.041). The multivariate Cox regression analysis suggested that tumour size, albumin-bilirubin grade, and PVTT type were independent prognostic factors. The C-index value of the nomogram based on these predictors in the entire cohort was 0.731 (0.628–0.833).ConclusionsAfter the combined therapy of TACE and sorafenib, advanced HCC patients with segmental or subsegmental PVTT showed better survival than those with main PVTT. The nomogram can be applied to identify advanced HCC patients with PVTT who may benefit most from the combination treatment and be helpful for making decision in clinical practice.
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影响因子：
81.5
作者：
Llovet, Josep M.;Zucman-Rossi, Jessica;Gores, Gregory
通讯作者：
Gores, Gregory
影响因子：
5.1
作者：
Marrero, Jorge A;Pelletier, Shawn
通讯作者：
Pelletier, Shawn
影响因子：
25.7
作者：
Lencioni, Riccardo;Llovet, Josep M.;Bruix, Jordi
通讯作者：
Bruix, Jordi
影响因子：
1.5
作者：
Gilles, HoChong;Garbutt, Tonora;Landrum, Jasmine
通讯作者：
Landrum, Jasmine
DOI：
10.1016/s0015-6264(78)80335-6
发表时间：
1986
期刊：
The New Zealand medical journal
影响因子：
--
作者：
D. Woodfield
通讯作者：
D. Woodfield