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Intermediate stage hepatocellular carcinoma: Comparison of the value of inflammation-based scores in predicting progression-free survival of patients receiving transarterial chemoembolization
Journal of Cancer Research and Therapeutics ( IF 1.3 ) Pub Date : 2021-07-01 , DOI: 10.4103/jcrt.jcrt_29_21 Ying Liu 1 , Menting Shi 2 , Shuanggang Chen 3 , Weiqi Wan 2 , Lujun Shen 3 , Binyan Shen 4 , Han Qi 3 , Fei Cao 3 , Ying Wu 3 , Tao Huang 3 , Guanjian Chen 2 , Jinqing Mo 2 , Dongdong Ye 2 , Yinqi Zhang 2 , Ziqing Feng 2 , Weijun Fan 5
Context and Aims: The identification of inflammation-related prognostic heterogeneity in intermediate-stage hepatocellular carcinoma (HCC) can reveal more effective first-line treatments. Our study aimed to compare the intermediate-stage HCC patients' different inflammation-based scores in predicting their progression-free survival (PFS) after transarterial chemoembolization (TACE).
Materials and Methods: We analyzed retrospectively a total of 128 intermediate-stage HCC patients who received first-line TACE treatment. We used the Cox-proportional hazards modeling to identify the independent prognostic factors. We compared the inflammation-based scores abilities to predict the PFS through the time-dependent receiver operating characteristic curves and area under the curves.
Results: The multivariate analysis showed that tumor size and platelet-to-lymphocyte ratio (PLR) were the independent prognostic factors for PFS (P < 0.05). The PLR predicted the intermediate-stage HCC patients' PFS receiving the TACE treatment better than other inflammation-based scores (e.g., the neutrophil-to-lymphocyte ratio, the Glasgow Prognostic Score (GPS), the modified GPS, the Prognostic Index, the Prognostic Nutritional Index, the lymphocyte-to-monocyte ratio, and the systemic immune-inflammation index) (P < 0.05). An easy-to-use novel inflammation score based on tumor size – PLR-size score significantly improved the PFS prediction performance (P < 0.05).
Conclusions: As a first-line treatment, TACE was not well suitable for all intermediate-stage HCC patients, while the PLR was a better inflammation-based score than others. Tumor size should be regarded as an essential variable in affecting intermediate-stage HCC patients' first-line treatment strategies.
中文翻译：
中期肝细胞癌：基于炎症的评分在预测接受经动脉化疗栓塞的患者无进展生存期中的价值比较
背景和目的：鉴定中期肝细胞癌 (HCC) 中与炎症相关的预后异质性可以揭示更有效的一线治疗方法。我们的研究旨在比较中期 HCC 患者在预测经动脉化疗栓塞 (TACE) 后的无进展生存期 (PFS) 方面的不同炎症评分。
材料和方法：我们回顾性分析了总共 128 名接受一线 TACE 治疗的中期 HCC 患者。我们使用 Cox 比例风险模型来确定独立的预后因素。我们通过时间相关的受试者工作特征曲线和曲线下面积比较了基于炎症的评分预测 PFS 的能力。
结果：多因素分析显示肿瘤大小和血小板与淋巴细胞比值（PLR）是影响PFS的独立预后因素（P < 0.05）。PLR 预测接受 TACE 治疗的中期 HCC 患者的 PFS 优于其他基于炎症的评分（例如，中性粒细胞与淋巴细胞的比率、格拉斯哥预后评分 (GPS)、改良的 GPS、预后指数、预后营养指数、淋巴细胞与单核细胞比率和全身免疫炎症指数）（P < 0.05）。基于肿瘤大小的易于使用的新型炎症评分 - PLR 大小评分显着提高了 PFS 预测性能（P < 0.05）。
结论：作为一线治疗，TACE 并不适合所有中期 HCC 患者，而 PLR 是比其他更好的基于炎症的评分。肿瘤大小应被视为影响中期 HCC 患者一线治疗策略的重要变量。
更新日期：2021-07-12
Journal of Cancer Research and Therapeutics ( IF 1.3 ) Pub Date : 2021-07-01 , DOI: 10.4103/jcrt.jcrt_29_21 Ying Liu 1 , Menting Shi 2 , Shuanggang Chen 3 , Weiqi Wan 2 , Lujun Shen 3 , Binyan Shen 4 , Han Qi 3 , Fei Cao 3 , Ying Wu 3 , Tao Huang 3 , Guanjian Chen 2 , Jinqing Mo 2 , Dongdong Ye 2 , Yinqi Zhang 2 , Ziqing Feng 2 , Weijun Fan 5
Affiliation
Context and Aims: The identification of inflammation-related prognostic heterogeneity in intermediate-stage hepatocellular carcinoma (HCC) can reveal more effective first-line treatments. Our study aimed to compare the intermediate-stage HCC patients' different inflammation-based scores in predicting their progression-free survival (PFS) after transarterial chemoembolization (TACE).
Materials and Methods: We analyzed retrospectively a total of 128 intermediate-stage HCC patients who received first-line TACE treatment. We used the Cox-proportional hazards modeling to identify the independent prognostic factors. We compared the inflammation-based scores abilities to predict the PFS through the time-dependent receiver operating characteristic curves and area under the curves.
Results: The multivariate analysis showed that tumor size and platelet-to-lymphocyte ratio (PLR) were the independent prognostic factors for PFS (P < 0.05). The PLR predicted the intermediate-stage HCC patients' PFS receiving the TACE treatment better than other inflammation-based scores (e.g., the neutrophil-to-lymphocyte ratio, the Glasgow Prognostic Score (GPS), the modified GPS, the Prognostic Index, the Prognostic Nutritional Index, the lymphocyte-to-monocyte ratio, and the systemic immune-inflammation index) (P < 0.05). An easy-to-use novel inflammation score based on tumor size – PLR-size score significantly improved the PFS prediction performance (P < 0.05).
Conclusions: As a first-line treatment, TACE was not well suitable for all intermediate-stage HCC patients, while the PLR was a better inflammation-based score than others. Tumor size should be regarded as an essential variable in affecting intermediate-stage HCC patients' first-line treatment strategies.
中文翻译：
中期肝细胞癌：基于炎症的评分在预测接受经动脉化疗栓塞的患者无进展生存期中的价值比较
背景和目的：鉴定中期肝细胞癌 (HCC) 中与炎症相关的预后异质性可以揭示更有效的一线治疗方法。我们的研究旨在比较中期 HCC 患者在预测经动脉化疗栓塞 (TACE) 后的无进展生存期 (PFS) 方面的不同炎症评分。
材料和方法：我们回顾性分析了总共 128 名接受一线 TACE 治疗的中期 HCC 患者。我们使用 Cox 比例风险模型来确定独立的预后因素。我们通过时间相关的受试者工作特征曲线和曲线下面积比较了基于炎症的评分预测 PFS 的能力。
结果：多因素分析显示肿瘤大小和血小板与淋巴细胞比值（PLR）是影响PFS的独立预后因素（P < 0.05）。PLR 预测接受 TACE 治疗的中期 HCC 患者的 PFS 优于其他基于炎症的评分（例如，中性粒细胞与淋巴细胞的比率、格拉斯哥预后评分 (GPS)、改良的 GPS、预后指数、预后营养指数、淋巴细胞与单核细胞比率和全身免疫炎症指数）（P < 0.05）。基于肿瘤大小的易于使用的新型炎症评分 - PLR 大小评分显着提高了 PFS 预测性能（P < 0.05）。
结论：作为一线治疗，TACE 并不适合所有中期 HCC 患者，而 PLR 是比其他更好的基于炎症的评分。肿瘤大小应被视为影响中期 HCC 患者一线治疗策略的重要变量。
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