Prognosis Nomogram for Hepatocellular Carcinoma Patients with Portal Vein Invasion Undergoing Transarterial Chemoemboliz
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CLINICAL INVESTIGATION
INTERVENTIONAL ONCOLOGY
Prognosis Nomogram for Hepatocellular Carcinoma Patients with Portal Vein Invasion Undergoing Transarterial Chemoembolization Plus Sorafenib Treatment: A Retrospective Multicentre Study Lei Zhang1 • Jun-Hui Sun2 • Zhong-Heng Hou1 • Bin-Yan Zhong1 • Min-Jie Yang3,4,5 • Guan-Hui Zhou2 • Wan-Sheng Wang1 • Peng Huang1 Shen Zhang1 • Zhi Li1 • Xiao-Li Zhu1 • Zhi-Ping Yan3,4,5 • Cai-Fang Ni1
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Received: 28 April 2020 / Accepted: 25 June 2020 Springer Science+Business Media, LLC, part of Springer Nature and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE) 2020
Abstract Objectives To explore the outcomes of combined transarterial chemoembolization (TACE) with sorafenib in hepatocellular carcinoma (HCC) patients with portal vein tumour thrombus (PVTT) and to establish a prognostic prediction nomogram to differentiate target patients and stratify risk. Materials and Methods This multicentre, retrospective study consisted of 185 consecutive treatment-naı¨ve patients with HCC and PVTT treated with TACE plus sorafenib from three institutions between January 1st, 2012 and December 31st, 2017. The primary outcome measurement of the study was overall survival (OS). The type of PVTT
Lei Zhang, Jun-Hui Sun, Zhong-Heng Hou and Bin-Yan Zhong have contributed equally as joint first authors. Zhi-Ping Yan and Cai-Fang Ni have contributed equally as joint corresponding authors.
was classified by the Liver Cancer Study Group of Japan. The prognostic nomogram was established based on the predictors and was performed with interval validation. Results The median OS of the Vp1-3 and Vp4 groups was 12.4 months (11.7–18.9) and 8.5 months (7.6–11.2) (P = 0.00098), respectively, and there was a significant difference in the median OS between the Vp1-2 and Vp3 subgroups (16.4 months (12.2–27.9) vs. 10.9 months (8.4–18.1), P = 0.041). The multivariate Cox regression analysis suggested that tumour size, albumin-bilirubin grade, and PVTT type were independent prognostic factors. The C-index value of the nomogram based on these predictors in the entire cohort was 0.731 (0.628–0.833). Conclusions After the combined therapy of TACE and sorafenib, advanced HCC patients with segmental or subsegmental PVTT showed better survival than those with main PVTT. The nomogram can be applied to identify advanced HCC patients with PVTT who may benefit most from the combination treatment and be helpful for making decision in clinical practice.
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00270-020-02579-2) contains supplementary material, which is available to authorized users. & Zhi-Ping Yan [email protected] & Cai-Fang Ni [email protected] 1
Department of Interventional Radiology, The First Affiliated Hospital of Soochow University, No. 188, Shizi Street, Suzhou 215006, China
2
Hepatobiliary and Pancreatic Interventional Treatment Center, Division of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hos
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