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Prognosis Nomogram for Hepatocellular Carcinoma Patients with Portal Vein Invasion Undergoing Transarterial Chemoembolization Plus Sorafenib Treatment: A Retrospective Multicentre Study.
- Source :
-
Cardiovascular and interventional radiology [Cardiovasc Intervent Radiol] 2021 Jan; Vol. 44 (1), pp. 63-72. Date of Electronic Publication: 2020 Sep 23. - Publication Year :
- 2021
-
Abstract
- Objectives: To 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.<br />Materials and Methods: This 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.<br />Results: The 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) (Pā=ā0.00098), 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), Pā=ā0.041). 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).<br />Conclusions: After 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.
- Subjects :
- Adult
Aged
Aged, 80 and over
Antineoplastic Agents therapeutic use
Carcinoma, Hepatocellular diagnosis
Female
Humans
Liver Neoplasms diagnosis
Male
Middle Aged
Nomograms
Prognosis
Retrospective Studies
Treatment Outcome
Carcinoma, Hepatocellular therapy
Chemoembolization, Therapeutic methods
Liver Neoplasms therapy
Portal Vein pathology
Sorafenib therapeutic use
Subjects
Details
- Language :
- English
- ISSN :
- 1432-086X
- Volume :
- 44
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Cardiovascular and interventional radiology
- Publication Type :
- Academic Journal
- Accession number :
- 32965582
- Full Text :
- https://doi.org/10.1007/s00270-020-02579-2