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Expected outcomes and patients’selection before chemoembolization—“Six-and-Twelve or Pre-TACE-Predict”scores may help clinicians:Real-life French cohorts results

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World Journal of Clinical Cases 2021年第18期9卷 4559-4572页

作者： Xavier Adhoute Edouard Larrey Rodolphe Anty Patrick Chevallier Guillaume Penaranda Albert Tran Jean-Pierre Bronowicki Jean-Luc Raoul Paul Castellani HervéPerrier olivier bayle olivier Monnet Bernard Pol Marc Bourliere Department of Gastroenterology and Hepatology Hôpital Saint-JosephMarseille 13008France Department of Gastroenterology and Hepatology Hôpital Universitaire de l’ArchetNice 06000France Department of Radiology Hôpital Universitaire de l’ArchetNice 06000France Statistics Department AlphaBio LaboratoryMarseille 13003France Department of Gastroenterology and Hepatology Centre Hospitalo-Universitaire de NancyVandoeuvre les Nancy 54511France Department of Medical Oncology Institut de Cancérologie de l’OuestSite de NantesNantes 44805France Department of Radiology Hôpital Saint-JosephMarseille 13008France Department of Hepatobiliary Surgery Hôpital Saint-JosephMarseille 13008France

BACKGROUND Careful selection of hepatocellular carcinoma(HCC)patients prior to chemoembolization treatment is a daily reality,and is even more necessary with new available therapeutic options in *** propose two new models to better stratify patients and maximize clinical benefit:“6 and 12”and“pre/post-TACE-predict”(TACE,transarterial chemoembolization).METHODS We evaluated and compared their performance in predicting overall survival with other systems{Barcelona Clinic Liver Cancer(BCLC),Albumin-Bilirubin(ALBI)and NIACE[Number of tumor(s),Infiltrative HCC,alpha-fetoprotein,Child-Pugh(CP),and performance status]}in two HCC French cohorts of different stages enrolled between 2010 and *** The cohorts included 324 patients classified as BCLC stages A/B(cohort 1)and 137 patients classified as BCLC stages B/C(cohort 2).The majority of the patients had cirrhosis with preserved liver function.“Pre-TACE-predict”and“6 and 12”models identified three distinct categories of patients exhibiting different prognosis in cohort ***,their prognostic value was no better than the BCLC system or NIACE *** function based on CP and ALBI grades significantly impacted patient ***,the“post-TACE-predict”model had a higher predictive value than other *** stratification ability as well as predictive performance of these new models in an intermediate/advanced stage population was less efficient(cohort 2).CONCLUSION The newly proposed“Pre-TACE-predict”and“6 and 12”models offer an interesting stratification into three categories in a recommended TACE population,as they identify poor candidates,those with partial control and durable *** models'contribution was reduced in a population with advanced stage HCCs.

关键词： Hepatocellular carcinoma Transarterial chemoembolization Pre-TACEpredict Six-and-twelve Barcelona Clinic Liver Cancer Prognosis

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Barcelona clinic liver cancer nomogram and others staging/scoring systems in a French hepatocellular carcinoma cohort

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World Journal of Gastroenterology 2017年第14期23卷 2545-2555页

作者： Xavier Adhoute Guillaume Pénaranda Jean Luc Raoul Julien Edeline Jean-Frédéric Blanc Bernard Pol Manuela Campanile HervéPerrierO livier bayle olivier Monnet Patrick Beaurain Cyril Muller Paul Castellani Yves Patrice Le Treut Jean Pierre Bronowicki Marc Bourlière Department of Hepato-Gastroenterology Hopital Saint-Joseph Marseille Alpha Bio Laboratory Marseille Department of Hepato-Gastroenterology and Digestive Oncology Institut Paoli-Calmette Marseille Department of Hepato-Gastroenterology and Digestive Oncology Centre Eugène Marquis Rennes Department of Hepato-Gastroenterology Centre Hospitalo-Universitaire Saint-AndréBordeaux Department of Hepatobiliary Surgery Hopital Saint-Joseph Marseille Department of Radiology Hopital Saint-Joseph Marseille Department of Hepatobiliary Surgery Centre Hospitalo-Universitaire Timone Marseille Department of Hepato-Gastroenterology Centre Hospitalo-Universitaire de Nancy INSERM U954 Universitéde LorraineCHU de NancyVandoeuvre les Nancy

AIM To compare the performances of the Barcelona clinic liver cancer(BCLC) nomogram and others systems(BCLC, HKLC, CLIP, NIACE) for survival prediction in a large hepatocellular carcinoma(HCC) French *** Data were collected retrospectively from 01/2007 to 12/2013 in five French centers. Newly diagnosed HCC patients were analyzed. The discriminatory ability, homogeneity ability, prognostic stratification ability Akaike information criterion(AIC) and C-index were compared among scoring systems. RESULTS The cohort included 1102 patients, mostly men, median age 68 [60-74] years with cirrhosis(81%), child-Pugh A(73%), alcohol-related(41%), HCV-related(27%). HCC were multinodular(59%) and vascular invasion was present in 41% of cases. At time of HCC diagnosis BCLC stages were A(17%), B(16%), C(60%) and D(7%). First line HCC treatment was curative in 23.5%, palliative in 59.5%, BSC in 17% of our population. Median OS was 10.8 mo [4.9-28.0]. Each system distinguished different survival prognosis groups(P < 0.0001). The nomogram had the highest discriminatory ability, the highest C-index value. NIACE score had the lowest AIC value. The nomogram distinguished sixteen different prognosis groups. By classifying unifocal large HCC into tumor burden 1, the nomogram was less powerful. CONCLUSION In this French cohort, the BCLC nomogram and the NIACE score provided the best prognostic information, but the NIACE could even help treatment strategies.

关键词： Barcelona clinical liver cancer Hong kong liver cancer NIACE CLIP Hepatocellular carcinoma

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