TY - JOUR
T1 - Transarterial chemo-embolisation of hepatocellular carcinoma: Impact of liver function and vascular invasion
AU - Waked, Imam
AU - Berhane, Sarah
AU - Toyoda, Hidenori
AU - Chan, Stephen L.
AU - Stern, Nicholas
AU - Palmer, Daniel
AU - Tada, Toshifumi
AU - Yeo, Winnie
AU - Mo, Frankie
AU - Bettinger, Dominik
AU - Kirstein, Martha M.
AU - Iñarrairaegui, Mercedes
AU - Gomaa, Asmaa
AU - Vogel, Arndt
AU - Meyer, Tim
AU - Sangro, Bruno
AU - Lai, Paul
AU - Kumada, Takashi
AU - Johnson, Philip J.
PY - 2017/2/14
Y1 - 2017/2/14
N2 - Background:Transarterial chemo-embolisation (TACE) is recommended for patients with BCLC intermediate stage hepatocellular carcinoma (stage B), particularly in patients with good underlying liver function and minimal symptoms. The hepatoma arterial embolisation prognostic (HAP) score combines measures of liver function and tumour-related factors to offer a simple prognostic scoring system. The Albumin-Bilirubin (ALBI) grade permits assessment of the impact of liver function on survival. We aimed to investigate these two models and vascular invasion (VI).Methods:In an international cohort of 3030 patients undergoing TACE, we examined the impact of liver function as assessed by the ALBI score, the HAP score and VI on survival.Results:Classification according to ALBI grade resulted in non-overlapping survival curves in the overall data set and all regional cohorts. The HAP score was also validated. Tumour number, aetiology and VI were identified as additional independent prognostic risk factors not currently included in the HAP score. Survival was particularly poor for patients with VI.Conclusions:The ALBI grade categorised patients receiving TACE into three clear prognostic groups, thereby emphasising the importance of underlying liver function in the outcome of TACE. The HAP score has been validated internationally and the serious adverse impact of VI is clearly shown.
AB - Background:Transarterial chemo-embolisation (TACE) is recommended for patients with BCLC intermediate stage hepatocellular carcinoma (stage B), particularly in patients with good underlying liver function and minimal symptoms. The hepatoma arterial embolisation prognostic (HAP) score combines measures of liver function and tumour-related factors to offer a simple prognostic scoring system. The Albumin-Bilirubin (ALBI) grade permits assessment of the impact of liver function on survival. We aimed to investigate these two models and vascular invasion (VI).Methods:In an international cohort of 3030 patients undergoing TACE, we examined the impact of liver function as assessed by the ALBI score, the HAP score and VI on survival.Results:Classification according to ALBI grade resulted in non-overlapping survival curves in the overall data set and all regional cohorts. The HAP score was also validated. Tumour number, aetiology and VI were identified as additional independent prognostic risk factors not currently included in the HAP score. Survival was particularly poor for patients with VI.Conclusions:The ALBI grade categorised patients receiving TACE into three clear prognostic groups, thereby emphasising the importance of underlying liver function in the outcome of TACE. The HAP score has been validated internationally and the serious adverse impact of VI is clearly shown.
UR - http://www.scopus.com/inward/record.url?scp=85010869442&partnerID=8YFLogxK
U2 - 10.1038/bjc.2016.423
DO - 10.1038/bjc.2016.423
M3 - Journal articles
C2 - 28125820
AN - SCOPUS:85010869442
SN - 0007-0920
VL - 116
SP - 448
EP - 454
JO - British Journal of Cancer
JF - British Journal of Cancer
IS - 4
ER -
