Transcatheter chemoembolization for unresectable hepatocellular carcinoma and comparison of five staging systems
Aim: We compared the ability of five staging system to predict survival in patients with hepatocellular carcinoma (HCC) treated with chemoembolization. Methods: The study subjects were 214 patients with HCC treated with repeated chemoembolization alone using cisplatin and lipiodol. Predictors of s...
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| Published in | Hepatology research Vol. 40; no. 11; pp. 1082 - 1091 |
|---|---|
| Main Authors | , , , , , , , , , , , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
Melbourne, Australia
Blackwell Publishing Asia
01.11.2010
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| Subjects | |
| Online Access | Get full text |
| ISSN | 1386-6346 1872-034X 1872-034X |
| DOI | 10.1111/j.1872-034X.2010.00714.x |
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| Abstract | Aim: We compared the ability of five staging system to predict survival in patients with hepatocellular carcinoma (HCC) treated with chemoembolization.
Methods: The study subjects were 214 patients with HCC treated with repeated chemoembolization alone using cisplatin and lipiodol. Predictors of survival were assessed by multivariate analysis. Before chemoembolization was carried out, the modified Japan Integrated Staging (m‐JIS), Japan Integrated Staging (JIS score), Barcelona (BCLC) stage, Liver Cancer Study Group of Japan/Tumor–Node–Metastasis (LCSGJ/TNM) and Italian score (CLIP score) were checked. To validate the prognostic value of these staging systems, the survival curve was obtained and analyzed by the Kaplan–Meier method. Discriminatory ability and predictive power were compared using Akaike's information criterion (AIC) score and the likelihood ratio (LR) χ2.
Results: Overall survival was 1 year in 82.9%, 3 years in 39.9% and 5 years in 15.1%. Multivariate analysis identified more than 90% lipiodol accumulation (grade I) after the first chemoembolization (P = 0.001), absence of portal vein tumor thrombosis (PVTT) (P < 0.001) and liver damage A (P = 0.012) as independent determinants of survival. AIC score and the LR χ2 showed superior predictive power of the m‐JIS system in 95 patients with grade I accumulation of lipiodol after first chemoembolization.
Conclusion: The discriminate ability of the m‐JIS score is substantially better than those of other staging systems and has better prognostic predictive power in patients with grade I accumulation of lipiodol after first chemoembolization. |
|---|---|
| AbstractList | Aim:
We compared the ability of five staging system to predict survival in patients with hepatocellular carcinoma (HCC) treated with chemoembolization.
Methods:
The study subjects were 214 patients with HCC treated with repeated chemoembolization alone using cisplatin and lipiodol. Predictors of survival were assessed by multivariate analysis. Before chemoembolization was carried out, the modified Japan Integrated Staging (m‐JIS), Japan Integrated Staging (JIS score), Barcelona (BCLC) stage, Liver Cancer Study Group of Japan/Tumor–Node–Metastasis (LCSGJ/TNM) and Italian score (CLIP score) were checked. To validate the prognostic value of these staging systems, the survival curve was obtained and analyzed by the Kaplan–Meier method. Discriminatory ability and predictive power were compared using Akaike's information criterion (AIC) score and the likelihood ratio (LR) χ
2
.
Results:
Overall survival was 1 year in 82.9%, 3 years in 39.9% and 5 years in 15.1%. Multivariate analysis identified more than 90% lipiodol accumulation (grade I) after the first chemoembolization (
P
= 0.001), absence of portal vein tumor thrombosis (PVTT) (
P
< 0.001) and liver damage A (
P
= 0.012) as independent determinants of survival. AIC score and the LR χ
2
showed superior predictive power of the m‐JIS system in 95 patients with grade I accumulation of lipiodol after first chemoembolization.
Conclusion:
The discriminate ability of the m‐JIS score is substantially better than those of other staging systems and has better prognostic predictive power in patients with grade I accumulation of lipiodol after first chemoembolization. Aim: We compared the ability of five staging system to predict survival in patients with hepatocellular carcinoma (HCC) treated with chemoembolization. Methods: The study subjects were 214 patients with HCC treated with repeated chemoembolization alone using cisplatin and lipiodol. Predictors of survival were assessed by multivariate analysis. Before chemoembolization was carried out, the modified Japan Integrated Staging (m‐JIS), Japan Integrated Staging (JIS score), Barcelona (BCLC) stage, Liver Cancer Study Group of Japan/Tumor–Node–Metastasis (LCSGJ/TNM) and Italian score (CLIP score) were checked. To validate the prognostic value of these staging systems, the survival curve was obtained and analyzed by the Kaplan–Meier method. Discriminatory ability and predictive power were compared using Akaike's information criterion (AIC) score and the likelihood ratio (LR) χ2. Results: Overall survival was 1 year in 82.9%, 3 years in 39.9% and 5 years in 15.1%. Multivariate analysis identified more than 90% lipiodol accumulation (grade I) after the first chemoembolization (P = 0.001), absence of portal vein tumor thrombosis (PVTT) (P < 0.001) and liver damage A (P = 0.012) as independent determinants of survival. AIC score and the LR χ2 showed superior predictive power of the m‐JIS system in 95 patients with grade I accumulation of lipiodol after first chemoembolization. Conclusion: The discriminate ability of the m‐JIS score is substantially better than those of other staging systems and has better prognostic predictive power in patients with grade I accumulation of lipiodol after first chemoembolization. We compared the ability of five staging system to predict survival in patients with hepatocellular carcinoma (HCC) treated with chemoembolization.AIMWe compared the ability of five staging system to predict survival in patients with hepatocellular carcinoma (HCC) treated with chemoembolization.The study subjects were 214 patients with HCC treated with repeated chemoembolization alone using cisplatin and lipiodol. Predictors of survival were assessed by multivariate analysis. Before chemoembolization was carried out, the modified Japan Integrated Staging (m-JIS), Japan Integrated Staging (JIS score), Barcelona (BCLC) stage, Liver Cancer Study Group of Japan/Tumor-Node-Metastasis (LCSGJ/TNM) and Italian score (CLIP score) were checked. To validate the prognostic value of these staging systems, the survival curve was obtained and analyzed by the Kaplan-Meier method. Discriminatory ability and predictive power were compared using Akaike's information criterion (AIC) score and the likelihood ratio (LR) χ(2) .METHODSThe study subjects were 214 patients with HCC treated with repeated chemoembolization alone using cisplatin and lipiodol. Predictors of survival were assessed by multivariate analysis. Before chemoembolization was carried out, the modified Japan Integrated Staging (m-JIS), Japan Integrated Staging (JIS score), Barcelona (BCLC) stage, Liver Cancer Study Group of Japan/Tumor-Node-Metastasis (LCSGJ/TNM) and Italian score (CLIP score) were checked. To validate the prognostic value of these staging systems, the survival curve was obtained and analyzed by the Kaplan-Meier method. Discriminatory ability and predictive power were compared using Akaike's information criterion (AIC) score and the likelihood ratio (LR) χ(2) . Overall survival was 1 year in 82.9%, 3 years in 39.9% and 5 years in 15.1%. Multivariate analysis identified more than 90% lipiodol accumulation (grade I) after the first chemoembolization (P = 0.001), absence of portal vein tumor thrombosis (PVTT) (P < 0.001) and liver damage A (P = 0.012) as independent determinants of survival. AIC score and the LR χ(2) showed superior predictive power of the m-JIS system in 95 patients with grade I accumulation of lipiodol after first chemoembolization.RESULTS Overall survival was 1 year in 82.9%, 3 years in 39.9% and 5 years in 15.1%. Multivariate analysis identified more than 90% lipiodol accumulation (grade I) after the first chemoembolization (P = 0.001), absence of portal vein tumor thrombosis (PVTT) (P < 0.001) and liver damage A (P = 0.012) as independent determinants of survival. AIC score and the LR χ(2) showed superior predictive power of the m-JIS system in 95 patients with grade I accumulation of lipiodol after first chemoembolization.The discriminate ability of the m-JIS score is substantially better than those of other staging systems and has better prognostic predictive power in patients with grade I accumulation of lipiodol after first chemoembolization.CONCLUSIONThe discriminate ability of the m-JIS score is substantially better than those of other staging systems and has better prognostic predictive power in patients with grade I accumulation of lipiodol after first chemoembolization. We compared the ability of five staging system to predict survival in patients with hepatocellular carcinoma (HCC) treated with chemoembolization. The study subjects were 214 patients with HCC treated with repeated chemoembolization alone using cisplatin and lipiodol. Predictors of survival were assessed by multivariate analysis. Before chemoembolization was carried out, the modified Japan Integrated Staging (m-JIS), Japan Integrated Staging (JIS score), Barcelona (BCLC) stage, Liver Cancer Study Group of Japan/Tumor-Node-Metastasis (LCSGJ/TNM) and Italian score (CLIP score) were checked. To validate the prognostic value of these staging systems, the survival curve was obtained and analyzed by the Kaplan-Meier method. Discriminatory ability and predictive power were compared using Akaike's information criterion (AIC) score and the likelihood ratio (LR) χ(2) . Overall survival was 1 year in 82.9%, 3 years in 39.9% and 5 years in 15.1%. Multivariate analysis identified more than 90% lipiodol accumulation (grade I) after the first chemoembolization (P = 0.001), absence of portal vein tumor thrombosis (PVTT) (P < 0.001) and liver damage A (P = 0.012) as independent determinants of survival. AIC score and the LR χ(2) showed superior predictive power of the m-JIS system in 95 patients with grade I accumulation of lipiodol after first chemoembolization. The discriminate ability of the m-JIS score is substantially better than those of other staging systems and has better prognostic predictive power in patients with grade I accumulation of lipiodol after first chemoembolization. |
| Author | Hashimoto, Yoshimasa Katamura, Yoshio Kakizawa, Hideaki Kitamoto, Mikiya Kamada, Koji Nakanishi, Toshio Aikata, Hiroshi Hieda, Masashi Hiramatsu, Akira Waki, Koji Tanaka, Junko Takaki, Shintaro Takahashi, Shoichi Ishikawa, Masaki Chayama, Kazuaki Kawaoka, Tomokazu |
| Author_xml | – sequence: 1 givenname: Tomokazu surname: Kawaoka fullname: Kawaoka, Tomokazu organization: Department of Medicine and Molecular Science, Division of Frontier Medical Science, Graduate School of Biomedical Science, Hiroshima University, Departments of Gastroenterology – sequence: 2 givenname: Hiroshi surname: Aikata fullname: Aikata, Hiroshi email: aikata@hiroshima-u.ac.jp organization: Department of Medicine and Molecular Science, Division of Frontier Medical Science, Graduate School of Biomedical Science, Hiroshima University, Departments of Gastroenterology – sequence: 3 givenname: Shintaro surname: Takaki fullname: Takaki, Shintaro organization: Department of Medicine and Molecular Science, Division of Frontier Medical Science, Graduate School of Biomedical Science, Hiroshima University, Departments of Gastroenterology – sequence: 4 givenname: Yoshimasa surname: Hashimoto fullname: Hashimoto, Yoshimasa organization: Department of Medicine and Molecular Science, Division of Frontier Medical Science, Graduate School of Biomedical Science, Hiroshima University, Departments of Gastroenterology – sequence: 5 givenname: Yoshio surname: Katamura fullname: Katamura, Yoshio organization: Department of Medicine and Molecular Science, Division of Frontier Medical Science, Graduate School of Biomedical Science, Hiroshima University, Departments of Gastroenterology – sequence: 6 givenname: Akira surname: Hiramatsu fullname: Hiramatsu, Akira organization: Department of Medicine and Molecular Science, Division of Frontier Medical Science, Graduate School of Biomedical Science, Hiroshima University, Departments of Gastroenterology – sequence: 7 givenname: Koji surname: Waki fullname: Waki, Koji organization: Department of Medicine and Molecular Science, Division of Frontier Medical Science, Graduate School of Biomedical Science, Hiroshima University, Departments of Gastroenterology – sequence: 8 givenname: Shoichi surname: Takahashi fullname: Takahashi, Shoichi organization: Department of Medicine and Molecular Science, Division of Frontier Medical Science, Graduate School of Biomedical Science, Hiroshima University, Departments of Gastroenterology – sequence: 9 givenname: Koji surname: Kamada fullname: Kamada, Koji organization: Shobara Red Cross Hospital – sequence: 10 givenname: Mikiya surname: Kitamoto fullname: Kitamoto, Mikiya organization: Hiroshima Prefectural Hospital – sequence: 11 givenname: Toshio surname: Nakanishi fullname: Nakanishi, Toshio organization: Miyoshi Central Hospital, Miyoshi – sequence: 12 givenname: Masaki surname: Ishikawa fullname: Ishikawa, Masaki organization: Department of Radiology, Division of Medical Intelligence and Informatics, Programs for Applied Biomedicine, Graduate School of Biomedical Science, Hiroshima University – sequence: 13 givenname: Masashi surname: Hieda fullname: Hieda, Masashi organization: Department of Radiology, Division of Medical Intelligence and Informatics, Programs for Applied Biomedicine, Graduate School of Biomedical Science, Hiroshima University – sequence: 14 givenname: Hideaki surname: Kakizawa fullname: Kakizawa, Hideaki organization: Department of Radiology, Division of Medical Intelligence and Informatics, Programs for Applied Biomedicine, Graduate School of Biomedical Science, Hiroshima University – sequence: 15 givenname: Junko surname: Tanaka fullname: Tanaka, Junko organization: Department of Epidemiology, Infectious Disease Control and Prevention, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan – sequence: 16 givenname: Kazuaki surname: Chayama fullname: Chayama, Kazuaki organization: Department of Medicine and Molecular Science, Division of Frontier Medical Science, Graduate School of Biomedical Science, Hiroshima University, Departments of Gastroenterology |
| BackLink | https://cir.nii.ac.jp/crid/1572824501092503680$$DView record in CiNii https://www.ncbi.nlm.nih.gov/pubmed/20880059$$D View this record in MEDLINE/PubMed |
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Combination therapy of intraarterial 5-fluorouracil and systemic interferon-alpha for advanced hepatocellular carcinoma with portal venous invasion. 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versus symptomatic treatment in patients with advanced hepatocellular carcinoma: results of a randomized, controlled trial in a single institution publication-title: Hepatology – volume: 100 start-page: 1764 year: 2005 end-page: 71 article-title: Comparison of the usefulness of three staging systems for hepatocellular carcinoma (CLIP, BCLC, and JIS) in Japan publication-title: Am J Gastroenterol – volume: 5 start-page: 105 year: 2010 end-page: 12 article-title: Regular surveillance by imaging for early detection and better prognosis of hepatocellular carcinoma in patients infected with hepatitis C virus publication-title: J Gastroenterol – volume: 19 start-page: 329 year: 1999 end-page: 38 article-title: Prognosis of hepatocellular carcinoma: the BCLC staging classification publication-title: Semin Liver Dis – volume: 37 start-page: 429 year: 2003 end-page: 42 article-title: Systematic review of randomized trials for unresectable hepatocellular carcinoma: chemoembolization improves survival publication-title: Hepatology – volume: 55 start-page: 39 year: 1998 end-page: 47 article-title: Clinical pilot study of intrahepatic arterial chemotherapy with methotrexate, 5‐fluorouracil, cisplatin and subcutaneous interferon‐alpha‐2b for patients with locally advanced hepatocellular carcinoma publication-title: Oncology – volume: 32 start-page: 687 year: 2009 end-page: 94 article-title: Transarterial infusion chemotherapy using cisplatin‐lipiodol suspension with or without embolization for unresectable hepatocellular carcinoma publication-title: Cardiovasc Intervent Radiol – volume: 127 start-page: S179 year: 2004 end-page: 88 article-title: Chemoembolization for hepatocellular carcinoma publication-title: Gastroenterology – volume: 12 start-page: 847 year: 2001 end-page: 54 article-title: Long‐term prognosis of patients undergoing transcatheter arterial chemoembolization for unresectable hepatocellular carcinoma: comparison of cisplatin lipiodol suspension and doxorubicin hydrochloride emulsion publication-title: J Vasc Interv Radiol – volume: 24 start-page: 2137 year: 2006 end-page: 50 article-title: Patterns of cancer incidence, mortality, and prevalence across five continents: defining priorities to reduce cancer disparities in different geographic regions of the world publication-title: J Clin Oncol – volume: 11 start-page: 914 year: 2001 end-page: 21 article-title: Percutaneous radiofrequency ablation of small hepatocellular carcinoma: long‐term results publication-title: Eur Radiol – volume: 350 start-page: 1142 year: 1997 end-page: 3 article-title: Increase in primary liver cancer in the UK, 1979–94 publication-title: Lancet – volume: 24 start-page: 378 year: 2008 end-page: 90 article-title: Sorafenib in advanced hepatocellular carcinoma publication-title: N Engl J Med – volume: 43 start-page: 975 year: 2008 end-page: 81 article-title: Clinicopathological features, background liver disease, and survival analysis of HCV‐positive patients with 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| Snippet | Aim: We compared the ability of five staging system to predict survival in patients with hepatocellular carcinoma (HCC) treated with chemoembolization.... Aim: We compared the ability of five staging system to predict survival in patients with hepatocellular carcinoma (HCC) treated with chemoembolization.... We compared the ability of five staging system to predict survival in patients with hepatocellular carcinoma (HCC) treated with chemoembolization. The study... We compared the ability of five staging system to predict survival in patients with hepatocellular carcinoma (HCC) treated with chemoembolization.AIMWe... |
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| SubjectTerms | Akaike's information criterion chemoembolization cisplatin hepatocellular carcinoma staging systems |
| Title | Transcatheter chemoembolization for unresectable hepatocellular carcinoma and comparison of five staging systems |
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