In:
Oncology, S. Karger AG, Vol. 97, No. 5 ( 2019), p. 277-285
Abstract:
〈 b 〉 〈 i 〉 Background/Aim: 〈 /i 〉 〈 /b 〉 We evaluated clinical factors related to improved prognosis of unresectable hepatocellular carcinoma patients (u-HCC), who were treated with tyrosine kinase inhibitor (TKI) sequential therapy, including lenvatinib (LEN). 〈 b 〉 〈 i 〉 Materials/Methods: 〈 /i 〉 〈 /b 〉 We enrolled 84 u-HCC cases treated with TKIs including LEN from March 2018 to January 2019 (median age 71 years, 63 males, Child-Pugh score (CPS) 5/6/7 = 62/21/1, tumor-node-metastasis stage of Liver Cancer Study Group of Japan 6th (TNM-LCSGJ) II/III/IVa/IVb = 12/30/5/37, Barcelona Clinic Liver Cancer stage B/C = 33:51). Clinical findings at introduction of the initial TKI were retrospectively evaluated. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 The median albumin-bilirubin (ALBI) score at introduction of the initial TKI (sorafenib [SOR]/LEN = 80/4) was –2.56, and the past number of transarterial catheter chemoembolization was 3 (IQR: 2–5) (second-line: regorafenib [REG] /LEN/SOR = 31/49/4, third-line: LEN/REG = 31:1). The total period of administration with TKIs showed a good relationship with overall survival (OS) ( 〈 i 〉 r 〈 /i 〉 = 0.946, 95% confidence interval [CI]: 0.918–0.965, 〈 i 〉 p 〈 /i 〉 & #x3c; 0.001). The prognosis of the entire cohort was good (estimated median survival time: 46.4 months, 1-/2-/3-year OS rate [OSR] = 87.7/63.0/57.2%). A modified-ALBI grade (mALBI) of 2b (ALBI score & #x3e;–2.27) was the only significant factor at the start of the initial TKI for poor prognosis (hazard ratio 2.319, 95% CI: 1.064–5.052, 〈 i 〉 p 〈 /i 〉 = 0.034), while CPS (≥6) was not. Although there was no significant difference in TNM-LCSGJ ( 〈 i 〉 p 〈 /i 〉 = 0.213), the prognosis of patients with mALBI 1/2a ( 〈 i 〉 n 〈 /i 〉 = 66) showed better prognosis as compared to those with mALBI 2b ( 〈 i 〉 n 〈 /i 〉 = 18) (1-year/2-year/3-year OSR = 89.1/69.8/66% vs. 82.4/47.1/23.5%, 〈 i 〉 p 〈 /i 〉 = 0.029). 〈 b 〉 〈 i 〉 Conclusion: 〈 /i 〉 〈 /b 〉 Good hepatic function (mALBI 1/2a) at introduction of the initial TKI is a requirement for improved prognosis of u-HCC undergoing TKI sequential therapy.
Type of Medium:
Online Resource
ISSN:
0030-2414
,
1423-0232
Language:
English
Publisher:
S. Karger AG
Publication Date:
2019
detail.hit.zdb_id:
1483096-6
detail.hit.zdb_id:
250101-6
