Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
SHR Neuro Krebs Kardio Lipid Stoffw Microb
Hucke, F; Pinter, M; Graziadei, I; Bota, S; Vogel, W; Müller, C; Heinzl, H; Waneck, F; Trauner, M; Peck-Radosavljevic, M; Sieghart, W.
How to STATE suitability and START transarterial chemoembolization in patients with intermediate stage hepatocellular carcinoma.
J Hepatol. 2014; 61(6):1287-1296
Doi: 10.1016/j.jhep.2014.07.002
Web of Science
PubMed
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- Co-Autor*innen der Med Uni Graz
- Trauner Michael
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- Abstract:
- We aimed to establish an objective point score to guide the decision for the first treatment with transarterial chemoembolization (TACE) in patients with hepatocellular carcinoma (HCC). 277 patients diagnosed with HCC and treated with transarterial treatments between 1/2002 and 12/2011 at the Medical Universities of Vienna (training cohort) and Innsbruck (validation cohort) were included. We investigated the impact of baseline liver function and tumour load on overall survival (OS, log-rank test) and developed a point score (STATE-score: Selection for TrAnsarterial chemoembolisation TrEatment) in the training-cohort (n=131, Vienna) by using a stepwise Cox regression model. The STATE-score was externally validated in an independent validation cohort (n=146, Innsbruck) and thereafter combined with the Assessment for Retreatment with TACE (ART)-score to identify patients who are (un)suitable for TACE. The STATE-score starts with the serum-albumin level (g/L), which is reduced by 12 points each, if the tumour load exceeds the up-to-7 criteria and/or C-reactive protein (CRP) levels are ⩾1 mg/dl (maximum reduction: 24 points). The STATE-score differentiated 2 groups (<18, ⩾18 points) with distinct prognosis (median OS: 5.3 vs. 19.5 months; p<0.001) and a lower STATE-score was associated with short-term harm and increased mortality after TACE-1 (39% vs. 14% p<0.001). Sequential use of the STATE and the ART-score (START-strategy) identified the most (un)suitable patients for TACE. Results were confirmed in the external validation-cohort and were independent from recently proposed baseline selection tools. The STATE-score identifies patients who are (un)suitable for the first TACE. The START-strategy identified the best candidates for multiple TACE sessions. Copyright © 2014 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.
- Find related publications in this database (using NLM MeSH Indexing)
- Aged -
- Antineoplastic Agents - administration & dosage
- C-Reactive Protein - metabolism
- Carcinoma, Hepatocellular - metabolism
- Carcinoma, Hepatocellular - mortality
- Carcinoma, Hepatocellular - therapy
- Chemoembolization, Therapeutic - methods
- Cohort Studies -
- Female -
- Humans -
- Liver Neoplasms - metabolism
- Liver Neoplasms - mortality
- Liver Neoplasms - therapy
- Male -
- Middle Aged -
- Patient Selection -
- Regression Analysis -
- Retrospective Studies -
- Serum Albumin - metabolism
- Survival Rate -
- Treatment Outcome -
- Find related publications in this database (Keywords)
- Hepatocellular carcinoma
- TACE
- Prognosis
- HCC
- ART-score