Retrospective Cohort Study
Copyright ©The Author(s) 2018. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jan 28, 2018; 24(4): 484-493
Published online Jan 28, 2018. doi: 10.3748/wjg.v24.i4.484
Early prediction of survival in hepatocellular carcinoma patients treated with transarterial chemoembolization plus sorafenib
Xiao-Chun Meng, Bing-Hui Chen, Jing-Jun Huang, Wen-Sou Huang, Ming-Yue Cai, Jing-Wen Zhou, Yong-Jian Guo, Kang-Shun Zhu
Xiao-Chun Meng, Department of Radiology, the Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou 510655, Guangdong Province, China
Bing-Hui Chen, Department of Radiology, the Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai 519000, Guangdong Province, China
Jing-Jun Huang, Wen-Sou Huang, Ming-Yue Cai, Jing-Wen Zhou, Yong-Jian Guo, Kang-shun Zhu, Department of Minimally Invasive Interventional Radiology, the Second Affiliated Hospital of Guangzhou Medical University, Guangzhou 510260, Guangdong Province, China
Author contributions: Meng XC, Chen BH and Huang JJ contributed equally to this work; Meng XC and Zhu KS designed and supervised the research; Huang JJ, Huang WS, Cai MY, Zhou JW and Guo YJ performed the research; Chen BH and Cai MY analyzed the data; Huang JJ and Zhu KS wrote the paper; all authors have read and approved the final version to be published.
Supported by National Natural Science Foundation of China, No. 81371655 and No. 81571774; and Guangdong Natural Science Foundation, No. 2014A030313171.
Institutional review board statement: The study was reviewed and approved by the Second Affiliated Hospital of Guangzhou Medical University Institutional Review Board.
Informed consent statement: Patients were not required to give informed consent for this study because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: There are no conflicts of interest to declare.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Kang-Shun Zhu, MD, Doctor, Department of Minimally Invasive Interventional Radiology, the Second Affiliated Hospital of Guangzhou Medical University, 250 East Changgang Road, Guangzhou 510260, Guangdong Province, China. zhukangshun@gzhmu.edu.cn
Telephone: +86-20-34152264 Fax: +86-20-34152264
Received: October 28, 2017
Peer-review started: October 29, 2017
First decision: November 30, 2017
Revised: December 10, 2017
Accepted: December 20, 2017
Article in press: December 20, 2017
Published online: January 28, 2018
Processing time: 89 Days and 19.2 Hours
Abstract
AIM

To identify clinical biomarkers that could early predict improved survival in patients with advanced-stage hepatocellular carcinoma (HCC) treated with transarterial chemoembolization combined with sorafenib (TACE-S).

METHODS

We retrospectively evaluated the medical records of consecutive patients with advanced-stage HCC who underwent TACE-S from January 2012 to December 2015. At the first follow-up 4-6 wk after TACE-S (median, 38 d; range, 33-45 d), patients exhibiting the modified Response Evaluation Criteria in Solid Tumors (mRECIST)-evaluated complete response, partial response, and stable disease were categorized as early disease control. At this time point, multiple variables were analyzed to identify the related factors affecting survival.

RESULTS

Ninety-five patients were included in this study, and 60 of these patients achieved early disease control, with an overall disease control rate (DCR) of 63.2%. Patients who got sorafenib at the first TACE (no previous TACE) and patients without portal vein tumor thrombus (PVTT) had a higher DCR than those who underwent previous TACE before TACE-S (72.4% vs 48.6%, P = 0.019) and those with PVTT (75.5% vs 50.0%, P = 0.010). Early disease control after TACE-S, no previous TACE, and no PVTT were the independent prognostic factors for survival in the uni- and multivariate analyses.

CONCLUSION

The first follow-up 4-6 wk after TACE-S can be used as the earliest time point to assess the response to TACE-S, and patients with mRECIST-evaluated early disease control, no previous TACE, and no PVTT had better survival.

Keywords: Hepatocellular carcinoma; Transarterial chemoembolization; Sorafenib; Survival; Prognosis

Core tip: There are no clinical data/markers to early predict improved survival in patients with advanced-stage hepatocellular carcinoma treated with transarterial chemoembolization combined with sorafenib (TACE-S). In this study, we found that mRECIST-evaluated disease control (complete response, partial response, and stable disease) at the first follow-up 4-6 wk after TACE-S can be used as an early indicator of better survival from TACE-S. We also found that patients with previous TACE and portal vein tumor thrombus had a poor survival.