Estelle Rebillard, Nicolas De Abreu, Benjamin Buchard, Léon Muti, Mathieu Boulin, Bruno Pereira, Benoit Magnin, Armand Abergel
{"title":"AFP-DIAM Score to Predict Survival in Patients with Hepatocellular Carcinoma Before TACE: A French Multicenter Study.","authors":"Estelle Rebillard, Nicolas De Abreu, Benjamin Buchard, Léon Muti, Mathieu Boulin, Bruno Pereira, Benoit Magnin, Armand Abergel","doi":"10.1007/s10620-024-08639-8","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Transarterial chemoembolization (TACE) is recommended as a palliative treatment for patients of the B stage of the Barcelona Clinic Liver Cancer (BCLC) classification.</p><p><strong>Aims: </strong>To identify clinical, biological, and radiological predictors of survival in patients undergoing TACE and develop a pre-therapeutic prognostic score.</p><p><strong>Methods: </strong>191 adult cirrhotic patients treated for HCC with TACE at the University Hospital (UH) of Clermont-Ferrand (France) from 2007-2017 were retrospectively included. We investigated the impact of baseline liver function, patient characteristics, and tumor burden on overall survival and developed a prognostic score.</p><p><strong>Results: </strong>Patients had a median age of 66 years and 126 patients were Child A. The AFP-DIAM score distinguishes two groups with a significant difference in survival time (median OS 28.3 months in patients with a score = 0 versus 17.7 months in patients with a score > 0). AFP-DIAM was validated on an external cohort, is well calibrated, and has the best discrimination capacity (C-index) as compared to NIACE, HAP, STATE, and SIX TO TWELVE. AFP-DIAM and SIX TO TWELVE are the more easy-to-use scores. When AFP-DIAM and the SIX TO TWELVE scores were tested in the same statistical model, results confirmed a better AFP-DIAM performance.</p><p><strong>Conclusions: </strong>The AFP-DIAM is an easy-to-use score which allows to distinguish two groups with different prognosis before the first TACE session. Its use could provide further support to BCLC system to guide the therapeutic strategy of patients with HCC.</p>","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":"4259-4267"},"PeriodicalIF":2.5000,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Digestive Diseases and Sciences","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s10620-024-08639-8","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/9/25 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"GASTROENTEROLOGY & HEPATOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Transarterial chemoembolization (TACE) is recommended as a palliative treatment for patients of the B stage of the Barcelona Clinic Liver Cancer (BCLC) classification.
Aims: To identify clinical, biological, and radiological predictors of survival in patients undergoing TACE and develop a pre-therapeutic prognostic score.
Methods: 191 adult cirrhotic patients treated for HCC with TACE at the University Hospital (UH) of Clermont-Ferrand (France) from 2007-2017 were retrospectively included. We investigated the impact of baseline liver function, patient characteristics, and tumor burden on overall survival and developed a prognostic score.
Results: Patients had a median age of 66 years and 126 patients were Child A. The AFP-DIAM score distinguishes two groups with a significant difference in survival time (median OS 28.3 months in patients with a score = 0 versus 17.7 months in patients with a score > 0). AFP-DIAM was validated on an external cohort, is well calibrated, and has the best discrimination capacity (C-index) as compared to NIACE, HAP, STATE, and SIX TO TWELVE. AFP-DIAM and SIX TO TWELVE are the more easy-to-use scores. When AFP-DIAM and the SIX TO TWELVE scores were tested in the same statistical model, results confirmed a better AFP-DIAM performance.
Conclusions: The AFP-DIAM is an easy-to-use score which allows to distinguish two groups with different prognosis before the first TACE session. Its use could provide further support to BCLC system to guide the therapeutic strategy of patients with HCC.
背景：方法：回顾性纳入2007年至2017年在法国克莱蒙费朗大学医院（UH）接受TACE治疗的191例HCC成人肝硬化患者。我们研究了基线肝功能、患者特征和肿瘤负荷对总生存期的影响，并制定了预后评分：AFP-DIAM评分将患者分为两组，两组患者的生存时间差异显著（评分=0的患者中位OS为28.3个月，评分>0的患者中位OS为17.7个月）。AFP-DIAM 在外部队列中进行了验证，校准良好，与 NIACE、HAP、STATE 和 SIX TO TWELVE 相比，具有最佳的区分能力（C 指数）。AFP-DIAM 和 SIX TO TWELVE 更易于使用。在同一个统计模型中测试 AFP-DIAM 和 SIX TO TWELVE 分数时，结果证实 AFP-DIAM 的性能更好：AFP-DIAM是一种易于使用的评分，可在首次TACE治疗前区分预后不同的两组患者。它的使用可为 BCLC 系统提供进一步支持，指导 HCC 患者的治疗策略。
期刊介绍：
Digestive Diseases and Sciences publishes high-quality, peer-reviewed, original papers addressing aspects of basic/translational and clinical research in gastroenterology, hepatology, and related fields. This well-illustrated journal features comprehensive coverage of basic pathophysiology, new technological advances, and clinical breakthroughs; insights from prominent academicians and practitioners concerning new scientific developments and practical medical issues; and discussions focusing on the latest changes in local and worldwide social, economic, and governmental policies that affect the delivery of care within the disciplines of gastroenterology and hepatology.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
