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Predictive performance of the mHAP-II score in a real-life western cohort with hepatocellular carcinoma following trans-arterial chemoembolisation with drug-eluting beads (DEB-TACE)

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Title: Predictive performance of the mHAP-II score in a real-life western cohort with hepatocellular carcinoma following trans-arterial chemoembolisation with drug-eluting beads (DEB-TACE)
Authors: Felix Peisen, Michael Maurer, Ulrich Grosse, Konstantin Nikolaou, Roland Syha, Dominik Ketelsen, Christoph Artzner, Michael Bitzer, Marius Horger, Gerd Grözinger
Source: Eur Radiol
Publisher Information: Springer Science and Business Media LLC, 2020.
Publication Year: 2020
Subject Terms: Male, 0301 basic medicine, Gastrointestinal, 0303 health sciences, Carcinoma, Hepatocellular, Liver Neoplasms, Female [MeSH], Chemoembolisation, therapeutic, Injections, Intra-Arterial/methods [MeSH], Aged [MeSH], Liver Neoplasms/diagnosis [MeSH], Humans [MeSH], Carcinoma, Hepatocellular/diagnosis [MeSH], Antineoplastic Agents/administration, Chemoembolization, Therapeutic/methods [MeSH], Retrospective Studies [MeSH], Prognosis, Carcinoma, Hepatocellular/drug therapy [MeSH], Cohort Studies [MeSH], Microspheres [MeSH], Male [MeSH], Prognosis [MeSH], Microspheres, Neoplasm Staging/methods [MeSH], Liver Neoplasms/drug therapy [MeSH], Carcinoma, hepatocellular, Retrospective studies, Antineoplastic Agents, 3. Good health, Cohort Studies, 03 medical and health sciences, Injections, Intra-Arterial, Humans, Female, Chemoembolization, Therapeutic, Aged, Neoplasm Staging, Retrospective Studies
Description: ObjectivesTo evaluate the predictive performance of the modified hepatoma arterial embolisation prognostic II (mHAP-II) score in a real-life western hepatocellular carcinoma (HCC) cohort treated with drug-eluting bead-TACE and compare the mHAP-II with other scores in this cohort.MethodsOne hundred seventy-nine HCC patients (mean age 77 (± 9) years, 87% male) with one or more drug-eluting bead (DEB)-TACE sessions using 100–300 μm microspheres were retrospectively analysed. Performance analysis of the mHAP-II score was based on Mann-WhitneyUtests, the Kaplan-Meier method, log-rank tests, receiver operating characteristics, Akaike’s information criterion and Cox regression models.ResultsIn this population, HCC risk factors were mainly alcohol abuse (31%) and hepatitis C (28%). The median survival of the entire cohort was 29.4 months. mHAP-II classification of the cohort was mHAP-II B (30%), C (41%) and D (23%) respectively. Survival of all subgroups differed significantly from each other (eachp p = 0.03), indicating a superior performance of mHAP-II score compared with HAP score and BCLC. Tumour number ≥ two (HR 1.54), alpha-fetoprotein > 400 μg/l (HR 1.14), serum albumin 0.9 mg/dl (HR 1.58) contributed significantly in Cox proportional hazards regression (eachp ConclusionThe mHAP-II score can predict survival outcomes of western HCC patients undergoing DEB-TACE and further subdivide this heterogeneous group; however, certain limitations concerning the predictive power of mHAP-II score must be taken into account.Key Points• This retrospective study evaluated the predictive performance of the modified hepatoma arterial embolisation prognostic II (mHAP-II) score in a real-life western HCC cohort treated with drug-eluting bead-TACE.• Survival of all mHAP-II subgroups differed significantly, area under the curve for mHAP-II was 0.60 and Akaike’s information criterion was 21.8.• The mHAP-II score can predict survival outcomes of western HCC patients undergoing DEB-TACE and further subdivide this heterogeneous group. However, because the study is underpowered, true survival prediction may be more difficult to infer.
Document Type: Article
Other literature type
Language: English
ISSN: 1432-1084
0938-7994
DOI: 10.1007/s00330-020-06734-8
Access URL: https://link.springer.com/content/pdf/10.1007/s00330-020-06734-8.pdf
https://pubmed.ncbi.nlm.nih.gov/32125515
https://www.ncbi.nlm.nih.gov/pubmed/32125515
https://link.springer.com/article/10.1007/s00330-020-06734-8
https://pubmed.ncbi.nlm.nih.gov/32125515/
https://europepmc.org/article/MED/32125515
https://link.springer.com/article/10.1007/s00330-020-06734-8?error=cookies_not_supported&error=cookies_not_supported&error=cookies_not_supported&error=cookies_not_supported&error=cookies_not_supported&error=cookies_not_supported&error=cookies_not_supported&error=cookies_not_supported&error=cookies_not_supported&error=cookies_not_supported&error=cookies_not_supported&error=cookies_not_supported&error=cookies_not_supported&code=c00a22e4-3ad1-446d-9791-782189af8527&code=1a1ec4a2-a831-48fa-921a-36c3ea8a6172&code=bb844cf7-f600-4b37-9bdf-e99d4aec7dee&code=0e58225f-f3f5-4e3d-92e6-4829d9db444e&code=acd31c22-feea-4a38-8937-e99c72bc2dd4&code=e2da8544-afcb-40b1-baa8-28d616c4e6a9&code=f56284c7-c91f-4bb7-bf59-881105288c57&code=28719b9d-889b-481f-bd2f-d7461087230f&code=99bdef2e-3102-4490-a27f-83ae75cd4212&code=0837bebb-7a05-4f06-95f9-dffac3c20d4a&code=bd9a6af9-ab0f-4078-a656-59a6975df9bf&code=1b5391f4-8633-42d6-940f-48745fc28f11
https://repository.publisso.de/resource/frl:6469228
Rights: CC BY
Accession Number: edsair.doi.dedup.....b2debfbe2dc5e0b04bf0b987f521794f
Database: OpenAIRE
Description
Abstract:ObjectivesTo evaluate the predictive performance of the modified hepatoma arterial embolisation prognostic II (mHAP-II) score in a real-life western hepatocellular carcinoma (HCC) cohort treated with drug-eluting bead-TACE and compare the mHAP-II with other scores in this cohort.MethodsOne hundred seventy-nine HCC patients (mean age 77 (± 9) years, 87% male) with one or more drug-eluting bead (DEB)-TACE sessions using 100–300 μm microspheres were retrospectively analysed. Performance analysis of the mHAP-II score was based on Mann-WhitneyUtests, the Kaplan-Meier method, log-rank tests, receiver operating characteristics, Akaike’s information criterion and Cox regression models.ResultsIn this population, HCC risk factors were mainly alcohol abuse (31%) and hepatitis C (28%). The median survival of the entire cohort was 29.4 months. mHAP-II classification of the cohort was mHAP-II B (30%), C (41%) and D (23%) respectively. Survival of all subgroups differed significantly from each other (eachp p = 0.03), indicating a superior performance of mHAP-II score compared with HAP score and BCLC. Tumour number ≥ two (HR 1.54), alpha-fetoprotein > 400 μg/l (HR 1.14), serum albumin 0.9 mg/dl (HR 1.58) contributed significantly in Cox proportional hazards regression (eachp ConclusionThe mHAP-II score can predict survival outcomes of western HCC patients undergoing DEB-TACE and further subdivide this heterogeneous group; however, certain limitations concerning the predictive power of mHAP-II score must be taken into account.Key Points• This retrospective study evaluated the predictive performance of the modified hepatoma arterial embolisation prognostic II (mHAP-II) score in a real-life western HCC cohort treated with drug-eluting bead-TACE.• Survival of all mHAP-II subgroups differed significantly, area under the curve for mHAP-II was 0.60 and Akaike’s information criterion was 21.8.• The mHAP-II score can predict survival outcomes of western HCC patients undergoing DEB-TACE and further subdivide this heterogeneous group. However, because the study is underpowered, true survival prediction may be more difficult to infer.
ISSN:14321084
09387994
DOI:10.1007/s00330-020-06734-8