Full metadata record
DC Field | Value | Language |
---|---|---|
dc.contributor.author | 김휘영 | * |
dc.contributor.author | 남준열 | * |
dc.date.accessioned | 2019-12-03T16:30:31Z | - |
dc.date.available | 2019-12-03T16:30:31Z | - |
dc.date.issued | 2019 | * |
dc.identifier.issn | 2072-6694 | * |
dc.identifier.other | OAK-26147 | * |
dc.identifier.uri | https://dspace.ewha.ac.kr/handle/2015.oak/252325 | - |
dc.description.abstract | Background: For patients with hepatocellular carcinoma (HCC), the definition of refractoriness to transarterial chemoembolization (TACE), which might make them a candidate for systemic therapy, is still controversial. We aimed to derive and validate a tumor marker-based algorithm to define the refractoriness to TACE in patients with intermediate-stage HCC. Methods: This multi-cohort study was comprised of patients who underwent TACE for treatment-naive intermediate-stage HCC. We derived a prediction model for overall survival (OS) using the pre- and post-TACE model to predict tumor recurrence after living donor liver transplantation (MoRAL) (i.e., MoRAL score = 11x root protein induced by vitamin K absence-II + 2x root alpha-fetoprotein), which was proven to reflect both tumor burden and biologic aggressiveness of HCC in the explant liver, from a training cohort (n = 193). These results were externally validated in both an independent hospital cohort (from two large-volume centers, n = 140) and a Korean National Cancer Registry sample cohort (n = 149). Results: The changes in MoRAL score (Delta MoRAL) after initial TACE was an independent predictor of OS (MoRAL-increase vs. MoRAL-non-increase: adjusted hazard ratio (HR) = 2.18, 95% confidence interval (CI) = 1.37-3.46, p = 0.001; median OS = 18.8 vs. 37.8 months). In a subgroup of patients with a high baseline MoRAL score (>= 89.5, 25th percentile and higher), the prognostic impact of Delta MoRAL was more pronounced (MoRAL-increase vs. MoRAL-non-increase: HR = 3.68, 95% CI = 1.54-8.76, p < 0.001; median OS = 9.9 vs. 37.4 months). These results were reproduced in the external validation cohorts. Conclusion: The Delta MoRAL after the first TACE, a simple and objective index, provides refined prognostication for patients with intermediate-stage HCC. Proceeding to a second TACE may not provide additional survival benefits in cases of a MoRAL-increase after the first TACE in patients with a high baseline MoRAL score (>= 89.5), who might be candidates for systemic therapy. | * |
dc.language | English | * |
dc.publisher | MDPI | * |
dc.subject | tumor marker | * |
dc.subject | alpha-fetoprotein | * |
dc.subject | protein induced by vitamin K absence-II | * |
dc.subject | hepatocellular carcinoma | * |
dc.subject | tumor biology | * |
dc.title | Tumor Marker-Based Definition of the Transarterial Chemoembolization-Refractoriness in Intermediate-Stage Hepatocellular Carcinoma: A Multi-Cohort Study | * |
dc.type | Article | * |
dc.relation.issue | 11 | * |
dc.relation.volume | 11 | * |
dc.relation.index | SCIE | * |
dc.relation.index | SCOPUS | * |
dc.relation.journaltitle | CANCERS | * |
dc.identifier.doi | 10.3390/cancers11111721 | * |
dc.identifier.wosid | WOS:000502290100103 | * |
dc.identifier.scopusid | 2-s2.0-85074659149 | * |
dc.author.google | Yoon, Jun Sik | * |
dc.author.google | Sinn, Dong Hyun | * |
dc.author.google | Lee, Jeong-Hoon | * |
dc.author.google | Kim, Hwi Young | * |
dc.author.google | Lee, Cheol-Hyung | * |
dc.author.google | Kim, Sun Woong | * |
dc.author.google | Lee, Hyo Young | * |
dc.author.google | Nam, Joon Yeul | * |
dc.author.google | Chang, Young | * |
dc.author.google | Lee, Yun Bin | * |
dc.author.google | Cho, Eun Ju | * |
dc.author.google | Yu, Su Jong | * |
dc.author.google | Kim, Hyo-Cheol | * |
dc.author.google | Chung, Jin Wook | * |
dc.author.google | Kim, Yoon Jun | * |
dc.author.google | Yoon, Jung-Hwan | * |
dc.contributor.scopusid | 김휘영(56493773500) | * |
dc.contributor.scopusid | 남준열(57193006895) | * |
dc.date.modifydate | 20240601081000 | * |