Meng XC, Chen BH, Huang JJ, Huang WS, Cai MY, Zhou JW, Guo YJ, Zhu KS. Early prediction of survival in hepatocellular carcinoma patients treated with transarterial chemoembolization plus sorafenib. World J Gastroenterol 2018; 24(4): 484-493 [PMID: 29398869 DOI: 10.3748/wjg.v24.i4.484]
Corresponding Author of This Article
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
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Retrospective Cohort Study
Open-Access Policy of This Article
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/
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
ARTICLE HIGHLIGHTS
Research background
Recently, some studies recommended that the combination of transarterial chemoembolization (TACE) and sorafenib (TACE-S) may be used as an alternative for patients with advanced-stage HCC. However, it is still uncertain which patients can obtain survival benefits from TACE-S treatment.
Research motivation
The aim of this study was to find some clinical biomarkers that can early predict improved survival in patients with advanced-stage HCC treated with TACE-S therapy, which will be beneficial to the choice of the patients who received TACE-S therapy.
Research objectives
The objective of this study was to identify which clinical biomarkers that could early predict improved survival in patients with advanced-stage HCC treated with TACE-S. This may help us make decisions about subsequent therapies and choose the timing of sorafenib treatment.
Research methods
A retrospective study was performed. The mRECIST-evaluated early disease control (including complete response, partial response, and stable disease) and multiple clinical variables at the first follow-up 4-6 wk after TACE-S were analyzed to identify the factors affecting survival.
Research results
No previous TACE, the absence of portal vein tumor thrombus (PVTT), and mRECIST-evaluated disease control at the first follow-up assessment 4-6 wk after TACE-S were independent prognostic factors for better survival. The incidence and severity of adverse events are similar to that observed in previous study.
Research conclusions
The first follow-up 4-6 wk after TACE-S can be used as the earliest time point at which the response to TACE-S should be evaluated in patients with advanced-stage HCC. At this point, mRECIST-evaluated disease control could be considered a valuable early indicator for making subsequent therapeutic decisions and predicting long-term survival. In addition, patients who received previous TACE or had main PVTT had worse outcomes.
Research perspectives
A further prospective study is needed to confirm mRECIST-evaluated disease control at the first follow-up 4-6 wk after TACE-S as an early indicator for predicting improved survival in patients with advanced-stage HCC treated with TACE-S therapy.
