80 EUROPEAN NETWORK ON RADIOEMBOLISATION WITH 90Y-RESIN MICROSPHERES (ENRY) MULTICENTRE EVALUATION OF SURVIVAL, SAFETY AND LIVER FUNCTION FOR UNRESECTABLE HEPATOCELLULAR CARCINOMA (HCC)

2011 ◽  
Vol 54 ◽  
pp. S36 ◽  
Author(s):  
B. Sangro ◽  
G.M. Ettorre ◽  
R. Cianni ◽  
D. Gasparini ◽  
R. Golfieri ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Function ◽  
European Network ◽  
Unresectable Hepatocellular Carcinoma ◽  
Resin Microspheres

scholarly journals Baseline and Early Predictors of Good Patient Candidates for Second-Line after Sorafenib Treatment in Unresectable Hepatocellular Carcinoma

Cancers ◽  
2019 ◽  
Vol 11 (9) ◽  
pp. 1256 ◽  
Author(s):  
Hitomi Takada ◽  
Masayuki Kurosaki ◽  
Kaoru Tsuchiya ◽  
Yasuyuki Komiyama ◽  
Jun Itakura ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Function ◽  
Disease Progression ◽  
Kinase Inhibitors ◽  
Tumor Burden ◽  
Second Line ◽  
Inclusion Criteria ◽  
Sorafenib Treatment ◽  
Unresectable Hepatocellular Carcinoma ◽  
Early Predictors

Background: Recent advances in the development of tyrosine kinase inhibitors (TKIs) have enabled patients with unresectable hepatocellular carcinoma (HCC) to receive multiple TKIs in sequence. The aim of this study was to identify predictors of good candidates for second-line treatment after disease progression during sorafenib treatment. Methods: This is a retrospective cohort study of 190 consecutive HCC patients who were treated with sorafenib in our hospital. Three criteria of good candidates for second-line TKI at the time of disease progression during sorafenib treatment were defined as follows: criterion 1 was the same as the inclusion criteria of the regorafenib for patients with hepatocellular carcinoma who progressed on sorafenib treatment (RESORCE) study, criterion 2 was the inclusion criteria of the RESORCE study plus Child–Pugh score 5, and criterion 3 was the inclusion criteria of the RESORCE study plus albumin–bilirubin (ALBI) grade 1. Factors at baseline and at week 4 during sorafenib treatment were used to predict patients fulfilling each of these three criteria. Results: The distribution of patients was 29%, 13%, and 6% in criteria 1, 2, and 3, respectively. Significant factors for meeting criterion 1 was the combination of baseline albumin >3.7 g/dL (odds ratio (OR) 2.7) plus degree of decrease in albumin (Δalbumin) at week 4 <0.2 g/dL (OR 2.6), or the combination of baseline ALBI score <−2.33 (OR 2.5) and ΔALBI at week 4 <0.255 (OR 4.9). For criterion 2, the value of baseline albumin and ALBI score was identical to criterion 1; however, Δalbumin (<0.1 g/dL) and ΔALBI score (<0.19) became stricter. For criterion 3, the value of baseline albumin (>3.8 g/dL) and ALBI (<−2.55) became stricter, as did Δalbumin (<0.1 g/dL) and ΔALBI (<0.085). Furthermore, tumor burden (>11) was selected as an additional predictor (OR 5.4). Conclusion: Predictors to satisfy the RESORCE study inclusion criteria were as follows: preserved liver function at baseline, as reflected by albumin or ALBI score, and small deterioration of liver function early during sorafenib therapy, as reflected by Δalbumin or ΔALBI at week 4. Liver function at baseline and degree of change in liver function during sorafenib treatment need to be stricter for better outcomes of liver function with disease progression.

Impact of hepatic function and tumor extent on survival in patients with unresectable hepatocellular carcinoma treated with liver-directed therapies.

2016 ◽  
Vol 34 (4_suppl) ◽  
pp. 358-358
Author(s):  
Marisa E. Hill ◽  
Sanjib Basu ◽  
Bulent Arslan
Keyword(s):  
Hepatocellular Carcinoma ◽  
Overall Survival ◽  
Liver Function ◽  
Proportional Hazards ◽  
Medical Center ◽  
Cox Proportional Hazards ◽  
Rank Test ◽  
Unresectable Hepatocellular Carcinoma ◽  
The Difference ◽  
Tumor Extent

358 Background: Transarterial chemoembolization (TACE) has demonstrated survival advantage over best supportive care in patients with unresectable hepatocellular carcinoma (HCC), and non-randomized data suggests that survival in HCC treated with yttrium-90 radioembolization (90Y) is similar to that achieved with TACE. Eighty to 90% of patients with HCC have underlying cirrhosis, so survival analyses of liver-directed treatments (LDT) should take into account both tumor extent and liver function. Methods: We conducted a retrospective study to evaluate the effect of tumor extent and liver function on the survival of patients treated with TACE and/or 90Y for HCC. Patients with unresectable HCC treated at Rush University Medical Center between 2002 and 2014 were analyzed. Liver function parameters prior to first treatment were recorded for each patient, and survival measured from time of first treatment to death or last follow up was calculated. Statistical inference for overall survival was performed using Kaplan-Meier method, log-rank test, and Cox proportional hazards regression model. Results: The difference in overall survival between patients with unilobar disease and with bilobar disease (n=35 and 23, median survival of 19.4 and 12.8 months, respectively) was not found to be significant (p=0.838). However, the difference in overall survival among patients with Child Pugh A (n=22, median not reached), B (n=30, median= 11.4 months) and C (n=6, median=3.8 months) cirrhosis was strongly significant (p < 0.001). In a multivariate Cox proportional hazards analysis, the association of Child class (coded on an integer scale) with overall survival, adjusted by the extent of the disease, continued to be strongly significant (HR=1.93, p < 0.001). Conclusions: Liver function may be just as important a determinant of survival in patients undergoing liver directed treatments for HCC as is extent of disease. Larger, prospective studies are needed to confirm this hypothesis.

Liver Function in Older Patients With Unresectable Hepatocellular Carcinoma After Administration of Lenvatinib

2021 ◽  
Vol 41 (4) ◽  
pp. 2025-2032
Author(s):  
RYU SASAKI ◽  
MASANORI FUKUSHIMA ◽  
MASAFUMI HARAGUCHI ◽  
SATOSHI MIUMA ◽  
HISAMITSU MIYAAKI ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Function ◽  
Older Patients ◽  
Unresectable Hepatocellular Carcinoma

scholarly journals Cost-utility analysis of selective internal radiation therapy with Y-90 resin microspheres in hepatocellular carcinoma

2020 ◽  
Author(s):  
Noemi Muszbek ◽  
Edit Remak ◽  
Rachel Evans ◽  
Victoria K Brennan ◽  
Fabien Colaone ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Radiation Therapy ◽  
Cost Utility ◽  
Phase Iii ◽  
Selective Internal Radiation Therapy ◽  
Internal Radiation ◽  
Unresectable Hepatocellular Carcinoma ◽  
Selective Internal Radiation ◽  
Internal Radiation Therapy ◽  
Resin Microspheres

Background: The study assessed the cost-utility of selective internal radiation therapy (SIRT) with Y-90 resin microspheres versus sorafenib in UK patients with unresectable hepatocellular carcinoma ineligible for transarterial chemoembolization. Materials & methods: A lifetime partitioned survival model was developed for patients with low tumor burden (≤25%) and good liver function (albumin–bilirubin grade 1). Efficacy, safety and quality of life data were from a European Phase III randomized controlled trial and published studies. Resource use was from registries and clinical surveys. Results: Discounted quality-adjusted life-years were 1.982 and 1.381, and discounted total costs were £29,143 and 30,927, for SIRT and sorafenib, respectively. Conclusion: SIRT has the potential to be a dominant (more efficacious/less costly) or cost-effective alternative to sorafenib in patients with unresectable hepatocellular carcinoma.

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