经动脉化疗栓塞将不可切除的肝细胞癌降期为治愈性治疗的

StephenW

经动脉化疗栓塞将不可切除的肝细胞癌降期为治愈性治疗的疗效：预测回归模型
林浩民 1 , 罗斌 # 1 , 彭芳一 1 , 程芳 1 , 于干 1 , 杨晓丽 1 , 李伯 1 , 李雅玲 2 , 宋苏 3
隶属关系
隶属关系

    1
    【作者单位】： 四川省泸州市西南医科大学附属医院普通外科（肝胆外科）
    2
    【作者单位】： 四川省泸州市西南医科大学药学院; [email protected]。
    3
    【作者单位】： 四川省泸州市西南医科大学附属医院普通外科（肝胆外科） [email protected]。

#
同等贡献。

    PMID：35723760 DOI：10.1007/s10637-022-01261-3

抽象的

米兰标准 (MC) 以外的肝细胞癌 (HCC) 患者在成功降期后可能成为治愈性治疗的候选者。我们旨在通过 MC 外的经动脉化疗栓塞 (TACE) 确定患者无法切除的 HCC 成功降期的预测因子。我们对接受 TACE 降期的 MC 以外的不可切除 HCC 患者进行了一项回顾性研究。记录临床和实验室变量。我们确定了 101 名接受初始 TACE 的不可切除 HCC 患者，他们构成了本研究的推导集。以相同选择标准接受 TACE 治疗的 30 名患者作为外部验证集。我们进行了单变量和多变量逻辑回归分析，以确定与成功降期相关的变量。然后我们做了预测模型来预测 TACE 的效率。在研究的 101 名患者中，26 名患者（25.7%）成功降期，75 名患者（74.3%）降期失败。多因素分析预测 MC 以外 HCC 成功降期的因素：肿瘤数量（P = 0.01）、门静脉肿瘤血栓形成（PVTT）（p < 0.01）、肿瘤大小（P = 0.02）、乙型肝炎表面抗原（ HBsAg) (P = 0.01)、甲胎蛋白 (AFP) (P = 0.02) 作为成功降期的重要预测因子。然后我们构建了预测模型。预测方程的 ROC 曲线下面积 (AUROC) 为 0.90（95% 置信区间，0.83-0.95）。我们在研究中发现，肿瘤的数量和大小、PVTT、HBsAg 和 AFP 是 MC 外 TACE 患者无法切除的 HCC 成功降期的良好预测指标。

关键词：降级；肝细胞癌;经动脉化疗栓塞。

© 2022。作者获得 Springer Science+Business Media, LLC 的独家许可，该公司隶属于 Springer Nature。

StephenW

The efficacy of transarterial chemoembolization in downstaging unresectable hepatocellular carcinoma to curative therapy: a predicted regression model
Haomin Lin  1 , Bin Luo #  1 , Fangyi Peng  1 , Cheng Fang  1 , Yu Gan  1 , Xiaoli Yang  1 , Bo Li  1 , Yaling Li  2 , Song Su  3
Affiliations
Affiliations

    1
    Department of General Surgery (Hepatobiliary Surgery), The Affiliated Hospital of Southwest Medical University, Sichuan Province, Luzhou City, China.
    2
    School of Pharmacy, Southwest Medical University, Sichuan Province, Luzhou City, China. [email protected].
    3
    Department of General Surgery (Hepatobiliary Surgery), The Affiliated Hospital of Southwest Medical University, Sichuan Province, Luzhou City, China. [email protected].

#
Contributed equally.

    PMID: 35723760 DOI: 10.1007/s10637-022-01261-3

Abstract

Patients with hepatocellular carcinoma (HCC) outside Milan criteria (MC) may be candidates for curative therapy after successful downstaging. We aimed to identify the predictors of successful downstaging of unresectable HCC in patient by transarterial chemoembolization (TACE) outside MC. We performed a retrospective study on patients with unresectable HCC outside MC who received downstaging with TACE. Clinical and laboratory variables were recorded. We identified 101 patients with unresectable HCC who underwent initial TACE, who formed the derivation set of this study. Thirty patients who treated by TACE with the same selection criteria served as an external validation set. We performed univariate and multivariate logistic regression analyses to identify variables associated with successful downstaging. Then we did the predictive model to predict the efficiency of TACE. Of the 101 patients in the study, 26 patients (25.7%) were successfully downstaging and 75 patients (74.3%) failed downstaging. Multivariate analysis of factors to predict successful downstaging of HCC outside MC the number of tumor (P = 0.01), portal vein tumor thrombosis (PVTT)(p < 0.01), the size of tumor (P = 0.02), hepatitis B surface antigen (HBsAg) (P = 0.01), α-fetoprotein (AFP) (P = 0.02) as significant predictors of successful downstaging. Then we constructed the predictive model. The area under the ROC curve (AUROC) of the predictive equation was 0.90 (95% confidence interval, 0.83-0.95). We found in our study that the number and size of tumors, PVTT, HBsAg, and AFP are good predictors of successful downstaging of unresectable HCC in patients by TACE outside the MC.

Keywords: Downstaging; Hepatocellular carcinoma; Transarterial chemoembolization.

© 2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.

StephenW

https://www.researchsquare.com/article/rs-771914/latest.pdf