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題名 Risk factors for 1-year mortality in patients with intermediate-stage hepatocellular carcinoma treated solely with transcatheter arterial chemoembolization 作者 Lin, Chih-Lin;Hsieh, Chia-Feng;Chen, Tom;Lin, Tsung-Jung;Huang, Ting-Chang;Lee, Hsi-Chang;Chen, Kuan-Yang;Liao, Li-Ying;Wang, Chung-Kwe
林志陵;陳冠仰;王鐘貴貢獻者 心理系;神科所 關鍵詞 Alpha-fetoprotein;Cirrhosis;Intermediate-stage hepatocellular carcinoma;Transcatheter arterial chemoembolization 日期 2014-12 上傳時間 24-Aug-2015 10:55:32 (UTC+8) 摘要 Background/aims--Transcatheter arterial chemoembolization (TACE) is a main therapy for patients with intermediate-stage hepatocellular carcinoma (HCC). The purpose of our study was to determine the risk factors for 1-year mortality in patients treated solely with TACE.Methods--A total of 123 patients with intermediate-stage HCC treated solely with TACE were recruited from Ren-ai Branch, Taipei City hospital during the period from January 1998 to June 2013. Baseline characteristics and factors associated with 1-year mortality were analyzed.Results--There were 94 men (76.4%) and 29 women (23.6%) among 123 newly diagnosed intermediate-stage HCC patients treated solely with TACE. The mean age was 63 ± 11 years (range, 31–92 years). The 1–5-year overall cumulative survival rates were 65.9%, 46%, 33.2%, 22%, and 18.4% [median: 23 months, 95% confidence interval (CI): 16.4–29.6 months], respectively. Of these, 42 (34.1%) and 81 (65.9%) patients had survival time shorter (Group 1) and longer (Group 2) than 1 year, respectively. There were no significant differences in sex, age, hepatitis B virus/hepatitis C virus positive rate and tumor number between Group 1 and Group 2 patients. Compared to Group 2, Group 1 patients had a significantly larger mean maximum tumor size (6.8 ± 3.2 cm vs. 5.3 ± 3.1 cm, p = 0.024), lower serum albumin level (3.4 ± 0.45 g/dL vs. 3.6 ± 0.46 g/dL, p = 0.011), higher serum bilirubin level (1.52 ± 1.07 mg/dL vs. 1.07 ± 0.59 mg/dL, p = 0.023), higher ratio of serum alpha-fetoprotein (AFP) > 400 ng/mL (52.4% vs. 24.7%, p = 0.003), and higher ratio of Child-Turcotte-Pugh (CTP) class B cirrhosis (26.2% vs. 6.2%, p = 0.003). Multivariate analysis revealed that AFP level > 400 ng/mL [hazard ratio (HR): 2.663, 95% CI: 1.143–6.205, p = 0.023], CTP class B cirrhosis (HR: 4.69, 95% CI: 1.399–15.715, p = 0.012) and tumor size (HR: 1.153 for each 1 cm increase, 95% CI: 1.015–1.310, p = 0.029) were independently associated with 1-year mortality.Conclusion--One-year mortality in patients with intermediate-stage HCC treated solely with TACE is not uncommon. High serum AFP level (> 400 ng/mL), CTP class B cirrhosis, and tumor size are independent risk factors for 1-year mortality in those patients. 關聯 Advances in Digestive Medicine, 1(4), 126-131 資料類型 article DOI http://dx.doi.org/10.1016/j.aidm.2013.12.001 dc.contributor 心理系;神科所 dc.creator (作者) Lin, Chih-Lin;Hsieh, Chia-Feng;Chen, Tom;Lin, Tsung-Jung;Huang, Ting-Chang;Lee, Hsi-Chang;Chen, Kuan-Yang;Liao, Li-Ying;Wang, Chung-Kwe dc.creator (作者) 林志陵;陳冠仰;王鐘貴 zh_TW dc.date (日期) 2014-12 dc.date.accessioned 24-Aug-2015 10:55:32 (UTC+8) - dc.date.available 24-Aug-2015 10:55:32 (UTC+8) - dc.date.issued (上傳時間) 24-Aug-2015 10:55:32 (UTC+8) - dc.identifier.uri (URI) http://nccur.lib.nccu.edu.tw/handle/140.119/77940 - dc.description.abstract (摘要) Background/aims--Transcatheter arterial chemoembolization (TACE) is a main therapy for patients with intermediate-stage hepatocellular carcinoma (HCC). The purpose of our study was to determine the risk factors for 1-year mortality in patients treated solely with TACE.Methods--A total of 123 patients with intermediate-stage HCC treated solely with TACE were recruited from Ren-ai Branch, Taipei City hospital during the period from January 1998 to June 2013. Baseline characteristics and factors associated with 1-year mortality were analyzed.Results--There were 94 men (76.4%) and 29 women (23.6%) among 123 newly diagnosed intermediate-stage HCC patients treated solely with TACE. The mean age was 63 ± 11 years (range, 31–92 years). The 1–5-year overall cumulative survival rates were 65.9%, 46%, 33.2%, 22%, and 18.4% [median: 23 months, 95% confidence interval (CI): 16.4–29.6 months], respectively. Of these, 42 (34.1%) and 81 (65.9%) patients had survival time shorter (Group 1) and longer (Group 2) than 1 year, respectively. There were no significant differences in sex, age, hepatitis B virus/hepatitis C virus positive rate and tumor number between Group 1 and Group 2 patients. Compared to Group 2, Group 1 patients had a significantly larger mean maximum tumor size (6.8 ± 3.2 cm vs. 5.3 ± 3.1 cm, p = 0.024), lower serum albumin level (3.4 ± 0.45 g/dL vs. 3.6 ± 0.46 g/dL, p = 0.011), higher serum bilirubin level (1.52 ± 1.07 mg/dL vs. 1.07 ± 0.59 mg/dL, p = 0.023), higher ratio of serum alpha-fetoprotein (AFP) > 400 ng/mL (52.4% vs. 24.7%, p = 0.003), and higher ratio of Child-Turcotte-Pugh (CTP) class B cirrhosis (26.2% vs. 6.2%, p = 0.003). Multivariate analysis revealed that AFP level > 400 ng/mL [hazard ratio (HR): 2.663, 95% CI: 1.143–6.205, p = 0.023], CTP class B cirrhosis (HR: 4.69, 95% CI: 1.399–15.715, p = 0.012) and tumor size (HR: 1.153 for each 1 cm increase, 95% CI: 1.015–1.310, p = 0.029) were independently associated with 1-year mortality.Conclusion--One-year mortality in patients with intermediate-stage HCC treated solely with TACE is not uncommon. High serum AFP level (> 400 ng/mL), CTP class B cirrhosis, and tumor size are independent risk factors for 1-year mortality in those patients. dc.format.extent 465848 bytes - dc.format.mimetype application/pdf - dc.relation (關聯) Advances in Digestive Medicine, 1(4), 126-131 dc.subject (關鍵詞) Alpha-fetoprotein;Cirrhosis;Intermediate-stage hepatocellular carcinoma;Transcatheter arterial chemoembolization dc.title (題名) Risk factors for 1-year mortality in patients with intermediate-stage hepatocellular carcinoma treated solely with transcatheter arterial chemoembolization dc.type (資料類型) article en dc.identifier.doi (DOI) 10.1016/j.aidm.2013.12.001 dc.doi.uri (DOI) http://dx.doi.org/10.1016/j.aidm.2013.12.001
