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Erschienen in: CardioVascular and Interventional Radiology 2/2018

06.09.2017 | Clinical Investigation

Survival Analysis of Advanced HCC Treated with Radioembolization: Comparing Impact of Clinical Performance Status Versus Vascular Invasion/Metastases

verfasst von: Rehan Ali, Ahmed Gabr, Nadine Abouchaleh, Ali Al Asadi, Ronald A. Mora, Laura Kulik, Michael Abecassis, Ahsun Riaz, Riad Salem, Robert J. Lewandowski

Erschienen in: CardioVascular and Interventional Radiology | Ausgabe 2/2018

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Abstract

Purpose

In this study, we aim to compare the effects of prognostic indicators on survival analysis for Barcelona Clinic Liver Cancer (BCLC) C patients undergoing yttrium-90 radioembolization (Y-90).

Methods

A prospectively acquired database (2003–2017) for BCLC C hepatocellular carcinoma (HCC) patients that underwent radioembolization with Y-90 was searched. The criteria for BCLC C status (Eastern Cooperative Oncology Group (ECOG) performance status (PS) of 1 or 2, metastases, and/or portal vein thrombosis (PVT)) were recorded. Kaplan–Meier survival analyses were performed from the date of the first radioembolization with Y-90, censored to curative treatment, to determine median overall survival (OS). Cox regression hazards model was used for multivariate analyses. Significance was set at P < 0.05.

Results

547 BCLC C patients treated with radioembolization with Y-90 had a median OS of 10.7 months (range: 9.5–12.9). 43% (233 of 547) patients classified as BCLC C solely by their ECOG PS had a median OS of 19.4 months (14.7–23.7); 57% (314 of 547) patients with PVT/metastases had a median OS of 7.7 months (6.7–8.7). On multivariate analysis, ECOG PS was not found to be a statistically significant prognostic indicator of OS in BCLC C whereas metastases and PVT exhibited hazards ratios (95%CI) of 0.51 (0.38–0.69) and 0.49 (0.38–0.63), respectively (P < 0.0001).

Conclusion

Patients classified as BCLC C due to ECOG PS 1 demonstrated longer survival when compared to those presenting with PVT, metastases and/or ECOG PS 2. Hence, ECOG PS 1, as an isolated variable, may not be a true indicator of advanced disease.
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Metadaten
Titel
Survival Analysis of Advanced HCC Treated with Radioembolization: Comparing Impact of Clinical Performance Status Versus Vascular Invasion/Metastases
verfasst von
Rehan Ali
Ahmed Gabr
Nadine Abouchaleh
Ali Al Asadi
Ronald A. Mora
Laura Kulik
Michael Abecassis
Ahsun Riaz
Riad Salem
Robert J. Lewandowski
Publikationsdatum
06.09.2017
Verlag
Springer US
Erschienen in
CardioVascular and Interventional Radiology / Ausgabe 2/2018
Print ISSN: 0174-1551
Elektronische ISSN: 1432-086X
DOI
https://doi.org/10.1007/s00270-017-1791-1

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