Refining Prognosis in Chemoembolization for Hepatocellular Carcinoma: Immunonutrition and Liver Function

Cancers

Roman Kloeckner¹  Christoph Düber¹  Felix Hahn¹  Lukas Müller¹  Fabian Stoehr¹  Aline Mähringer-Kunz¹  Michael Bernhard Pitton¹  Jens Mittler²  Peter Robert Galle³  Arndt Weinmann³  Simon Johannes Gairing³  Friedrich Foerster³  Daniel Pinto dos Santos⁴ 

[1] Department of Diagnostic and Interventional Radiology, University Medical Center of the Johannes Gutenberg University Mainz, 55131 Mainz, Germany;Department of General, Visceral and Transplant Surgery, University Medical Center of the Johannes Gutenberg University Mainz, 55131 Mainz, Germany;Department of Internal Medicine, University Medical Center of the Johannes Gutenberg University Mainz, 55131 Mainz, Germany;Department of Radiology, University Hospital of Cologne, 50937 Cologne, Germany;

关键词: hepatocellular carcinoma;    transarterial chemoembolization;    risk prediction;    albumin-bilirubin grade;    prognostic nutritional index;   

DOI  :  10.3390/cancers13163961

来源: DOAJ

【 摘 要 】

A combination of albumin-bilirubin (ALBI) grading and the Prognostic Nutritional Index (PNI) was identified recently as a highly predictive tool for patients with hepatocellular carcinoma (HCC) undergoing tumor ablation. The present study evaluated this combination in patients undergoing transarterial chemoembolization (TACE). Between 2010 and 2020, 280 treatment-naïve patients were retrospectively identified. The influence of ALBI grade, PNI and the novel ALBI-PNI on the median overall survival (OS) was assessed. In the next step, the prognostic ability of the combined approach was compared to established scoring systems. Both ALBI grade 2−3 and a low PNI were highly predictive for median OS (ALBI grade 1–3: 39.0 vs. 16.3 vs. 5.4 months, p < 0.001; high vs. low PNI: 21.4 vs. 7.5, p < 0.001). The combination of both resulted in a median OS of 39.0, 20.1, 10.3, and 5.4 months (p < 0.001). With a Concordance Index (C-Index) of 0.69, ALBI-PNI outperformed each individual score (ALBI 0.65, PNI 0.64) and was also better than BCLC, HAP, mHAP-II, and the Six-and-Twelve score (C-Indices 0.66, 0.60, 0.59, and 0.55). Thus, the easy-to-calculate ALBI-PNI may be a promising stratification tool for patients with HCC undergoing TACE, reflecting both immunonutritive status and liver function.

【 授权许可】

Unknown