Nutritional Status Is Associated with Prognosis in Patients with Advanced Unresectable Hepatocellular Carcinoma Treated with Atezolizumab plus Bevacizumab
Nutritional Status Is Associated with Prognosis in Patients with Advanced Unresectable Hepatocellular Carcinoma Treated with Atezolizumab plus Bevacizumab
复制标题
营养状况与接受 Atezolizumab 加贝伐单抗治疗的晚期不可切除肝细胞癌患者的预后相关
作者：
Tada Toshifumi;Kumada Takashi;Hiraoka Atsushi;Hiasa Yoichi;et al.
本研究调查了营养状况之间的关系，由预后营养指数（PNI）确定，atezolizumab联合贝伐珠单抗治疗不可切除肝细胞癌（HCC）患者的疗效和结局方法对485例接受Atez/bev治疗的HCC患者进行分析。结果342例患者的PNI较低（< 47），143例患者的PNI较高（≥ 47）。中位随访时间为9.4（6.0-14.3）个月。多变量考克斯风险分析显示，甲胎蛋白水平≥ 100 ng/mL（风险比（HR），2.217; 95%置信区间（CI），1.588-3.095; p< 0.001）和PNI≥ 47（HR，0.333; 95% CI，0.212-0.525; p< 0.001）与总生存期独立相关。多变量分析显示，甲胎蛋白水平≥ 100 ng/mL（HR，1.690; 95% CI，1.316-2.170; p< 0.001）和PNI≥ 47（HR，0.696; 95% CI，0.528-0.918; p= 0.010）与无进展生存期独立相关。PNI组的累积总生存率和无进展生存率差异显著（分别为p< 0.001和p< 0.002）。在白蛋白-胆红素1级患者（n= 173）中使用逆概率加权调整的亚组分析中，单变量考克斯风险分析显示PNI≥ 47（HR，0.502; 95% CI，0.260-0.991; p= 0.047）与总生存期显著相关。样条曲线分析显示，PNI约34-48是一个适当的截止预测良好的整体和无进展survival.ConclusionThe PNI，营养状况的生物标志物，可以预测预后的HCC患者与阿替兹/贝弗治疗，即使是那些被认为有一个良好的预后，由于良好的肝功能。
IntroductionThis study investigated the relationship between nutritional status, as determined by the prognostic nutritional index (PNI), and outcomes in patients with unresectable hepatocellular carcinoma (HCC) treated with atezolizumab plus bevacizumab (Atez/bev).MethodsThe study analyzed 485 HCC patients treated with Atez/bev.ResultsThere were 342 patients with a low PNI (< 47) and 143 patients with a high PNI (≥ 47). The median follow-up duration was 9.4 (6.0–14.3) months. Multivariate Cox hazards analysis showed that an α-fetoprotein level≥ 100 ng/mL (hazard ratio (HR), 2.217; 95% confidence interval (CI), 1.588–3.095; p< 0.001), and PNI≥ 47 (HR, 0.333; 95% CI, 0.212–0.525; p< 0.001) were independently associated with overall survival. Multivariate analysis showed that an α-fetoprotein level≥ 100 ng/mL (HR, 1.690; 95% CI, 1.316–2.170; p< 0.001) and PNI≥ 47 (HR, 0.696; 95% CI, 0.528–0.918; p= 0.010) were independently associated with progression-free survival. Cumulative overall and progression-free survival rates differed significantly by PNI (p< 0.001 and p< 0.002, respectively). In a subgroup analysis using inverse probability weighting adjustment in patients with albumin-bilirubin grade 1 (n= 173), univariate Cox hazards analysis showed that a PNI≥ 47 (HR, 0.502; 95% CI, 0.260–0.991; p= 0.047) was significantly associated with overall survival. Spline curve analysis revealed that a PNI of approximately 34–48 is an appropriate cutoff for predicting good overall and progression-free survival.ConclusionThe PNI, a biomarker of nutritional status, can predict prognosis in patients with HCC treated with Atez/bev, even those who are considered to have a good prognosis due to good liver function.
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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
早期乐伐替尼给药对中期肝细胞癌患者生存的影响：多中心逆概率加权分析
影响因子：
3.5
作者：
Tada T;Kumada T;Hiraoka A;Michitaka K;Atsukawa M;Hirooka M;Tsuji K;Ishikawa T;Takaguchi K;Kariyama K;Itobayashi E;Tajiri K;Shimada N;Shibata H;Ochi H;Yasuda S;Toyoda H;Fukunishi S;Ohama H;Kawata K;Nakamura S;Nouso K;Tsutsui A;Nagano T;Hiasa Y;et al.
通讯作者：
et al.
影响因子：
13.8
作者：
Kumada, Takashi;Toyoda, Hidenori;Tanaka, Junko
通讯作者：
Tanaka, Junko
影响因子：
28.4
作者：
Pinter M;Jain RK;Duda DG
通讯作者：
Duda DG
影响因子：
4.1
作者：
Tada, Toshifumi;Kumada, Takashi;Yama, Tsuyoki
通讯作者：
Yama, Tsuyoki