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

Abstract

PurposeIn 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).MethodsA 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.Results547 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).ConclusionPatients classified as BCLC Cmore » 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.« less

Authors:
; ; ; ;  [1];  [2];  [3]; ; ;  [1]
  1. Northwestern Memorial Hospital, Robert H. Lurie Comprehensive Cancer Center, Section of Interventional Radiology, Department of Radiology (United States)
  2. Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Division of Hematology and Oncology, Department of Medicine (United States)
  3. Northwestern University, Division of Transplantation, Department of Surgery, Comprehensive Transplant Center (United States)
Publication Date:
OSTI Identifier:
22756314
Resource Type:
Journal Article
Journal Name:
Cardiovascular and Interventional Radiology
Additional Journal Information:
Journal Volume: 41; Journal Issue: 2; Conference: ECIO 2018: European Conference on Interventional Oncology, Vienna (Austria), 22-25 Apr 2018; Other Information: Copyright (c) 2018 Springer Science+Business Media, LLC, part of Springer Nature and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE); Article Copyright (c) 2017 Springer Science+Business Media, LLC and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE); http://www.springer-ny.com; Country of input: International Atomic Energy Agency (IAEA); Journal ID: ISSN 0174-1551
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; INDICATORS; MULTIVARIATE ANALYSIS; NEOPLASMS; PATIENTS; RADIOEMBOLIZATION; YTTRIUM 90

Citation Formats

Ali, Rehan, Gabr, Ahmed, Abouchaleh, Nadine, Al Asadi, Ali, Mora, Ronald A., Kulik, Laura, Abecassis, Michael, Riaz, Ahsun, Salem, Riad, and Lewandowski, Robert J., E-mail: r-lewandowski@northwestern.edu. Survival Analysis of Advanced HCC Treated with Radioembolization: Comparing Impact of Clinical Performance Status Versus Vascular Invasion/Metastases. United States: N. p., 2018. Web. doi:10.1007/S00270-017-1791-1.
Ali, Rehan, Gabr, Ahmed, Abouchaleh, Nadine, Al Asadi, Ali, Mora, Ronald A., Kulik, Laura, Abecassis, Michael, Riaz, Ahsun, Salem, Riad, & Lewandowski, Robert J., E-mail: r-lewandowski@northwestern.edu. Survival Analysis of Advanced HCC Treated with Radioembolization: Comparing Impact of Clinical Performance Status Versus Vascular Invasion/Metastases. United States. doi:10.1007/S00270-017-1791-1.
Ali, Rehan, Gabr, Ahmed, Abouchaleh, Nadine, Al Asadi, Ali, Mora, Ronald A., Kulik, Laura, Abecassis, Michael, Riaz, Ahsun, Salem, Riad, and Lewandowski, Robert J., E-mail: r-lewandowski@northwestern.edu. Thu . "Survival Analysis of Advanced HCC Treated with Radioembolization: Comparing Impact of Clinical Performance Status Versus Vascular Invasion/Metastases". United States. doi:10.1007/S00270-017-1791-1.
@article{osti_22756314,
title = {Survival Analysis of Advanced HCC Treated with Radioembolization: Comparing Impact of Clinical Performance Status Versus Vascular Invasion/Metastases},
author = {Ali, Rehan and Gabr, Ahmed and Abouchaleh, Nadine and Al Asadi, Ali and Mora, Ronald A. and Kulik, Laura and Abecassis, Michael and Riaz, Ahsun and Salem, Riad and Lewandowski, Robert J., E-mail: r-lewandowski@northwestern.edu},
abstractNote = {PurposeIn 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).MethodsA 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.Results547 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).ConclusionPatients 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.},
doi = {10.1007/S00270-017-1791-1},
journal = {Cardiovascular and Interventional Radiology},
issn = {0174-1551},
number = 2,
volume = 41,
place = {United States},
year = {2018},
month = {2}
}