scholarly journals Hepatoceliulinės karcinomos prognostinės sistemos

2008 ◽  
Vol 6 (3) ◽  
pp. 0-0
Author(s):  
Jonas Pivoriūnas ◽  
Jonas Jurgaitis ◽  
Marius Paškonis ◽  
Agnius Juška ◽  
Janina Didžiapetrienė ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Primary Liver Cancer ◽  
Prognostic Score ◽  
Scoring Systems ◽  
The United States ◽  
University Hospital ◽  
Prognostic Scores ◽  
Key Words Hepatocellular Carcinoma ◽  
Staging Systems ◽  
Vilnius University

Jonas Pivoriūnas1, Jonas Jurgaitis2, 3, Marius Paškonis2, 3, Agnius Juška1, Janina Didžiapetrienė3, Eugenijus Stratilovas3, Narimantas Evaldas Samalavičius3, Vitalijus Sokolovas3, Gintautas Brimas2, Kęstutis Strupas21 Vilniaus universiteto Medicinos fakultetas, M. K. Čiurlionio g. 21, LT-03101 Vilnius2 Gastroenterologijos, urologijos ir abdominalinės chirurgijos klinika,Vilniaus universiteto ligoninės Santariškių klinikos, Santariškių g. 2, LT-08661 Vilnius3 Vilniaus universiteto Onkologijos institutas Santariškių g. 1, LT-08660 VilniusEl paštas: [email protected] Įvadas / tikslas Hepatoceliulinė karcinoma – tai penktas tarp dažniausių navikų pasaulyje ir trečias pagal mirštamumą. Per pastaruosius dešimtmečius sergamumas šiuo naviku didėja Jungtinėse Amerikos Valstijose ir Europoje. Lietuvoje hepatoceliulinės karcinomos atvejų taip pat daugėja. Manoma, kad kepenų navikų per kitus du dešimtmečius dar padaugės. Hepatoceliulinė karcinoma yra sunkiai įvertinama, heterogoniška liga, dėl to pasaulyje kuriamos prognostinės sistemos, kurios turi padėti gydytojui parinkti tinkamą gydymą ir įvertinti ligos prognozę. Šio straipsnio tikslas – išrinkti ir apibūdinti labiausiai pasaulyje paplitusias hepatoceliulinės karcinomos prognostines sistemas, palyginti jų taikymo rezultatus, parinkti Lietuvai tinkamiausias sistemas. Metodai Pasinaudojus „PubMed“ duomenų baze ir įvedus reikšminius žodžius hepatocellular carcinoma, prognostic scores ir staging system buvo rasti 205 straipsniai, publikuoti nuo 1984 iki 2007 metų. Atrinkti 54 straipsniai, kuriuose minimos 24-ios hepatoceliulinės karcinomos prognostinės sistemos. Rezultatai Išanalizavus sistemas buvo nuspręsta atmesti tas, kurių pritaikyti Lietuvoje nėra galimybių dėl to, kad šalyje neatliekami tyrimai. Plačiau aprašytos devynios sistemos. Išvados Išrinkę plačiausiai pasaulyje naudojamas hepatoceliulinės karcinomos prognostines sistemas ir palyginę jų taikymo rezultatus, manome, kad būtų vertinga atlikti retrospektyvųjį lyginamąjį tyrimą, kad išsiaiškintume, kokia prognostinė sistema geriausiai tinka hepatoceliuline karcinoma sergantiems Lietuvos populiacijos pacientams diferencijuoti pagal išgyvenamumą. Reikšminiai žodžiai: hepatoceliulinė karcinoma, prognostinė sistema, prognostiniai kriterijai, pacientų išgyvenamumas Prognostic scores of hepatocellular carcinoma Jonas Pivoriūnas1, Jonas Jurgaitis2, 3, Marius Paškonis2, 3, Agnius Juška1, Janina Didžiapetrienė3, Eugenijus Stratilovas3, Narimantas Evaldas Samalavičius3, Vitalijus Sokolovas3, Gintautas Brimas2, Kęstutis Strupas21 Vilnius University Faculty of Medicine, M. K. Čiurlionio str. 21, LT-03101 Vilnius, Lithuania2 Clinic of Gastroenterology, Urology and Abdominal Surgery,Vilnius University Hospital Santariškių Clinic, Santariškių str. 2, LT-08661 Vilnius, Lithuania3 Institute of Oncology, Vilnius University, Santariškių str. 1, LT-08660 Vilnius, LithuaniaE-mail: [email protected] Background / objective Hepatocellular carcinoma is the most common primary liver cancer. It is the fifth most common neoplasm and the third most common cause of cancer-related death in the world. Over the last decade the incidence of this cancer has been rising in the United States of America and in Europe as well as in Lithuania. The incidence of this cancer in the next two decades is expected to rise. Hepatocelullar carcinoma is a difficult and heterogenic disease. Therefore, prognostic scores are being created to help clinicians to choose the best treatment for the patient. The aim of this review is to select and describe the most widely used prognostic systems of hepatocellular carcinoma, to compare results of their usage, applicability and to choose the most suitable scoring systems for the further use in Lithuania. Methods The PubMed data base was used to search for the keywords: “hepatocellular carcinoma”, “prognostic scores” and “staging systems”. 205 published articles were found from the year 1984 though 2007; 54 articles with 24 prognostic systems were selected. Results Upon analysing the prognostic systems, it was decided to reject the scoring systems that are impossible to use in Lithuania because of the absence of related tests. In total, nine prognostic systems were overviewed. Conclusions A retrospective cohort study is advisable to ascertain which prognostic system of hepatocellular carcinoma is most suitable for Lithuanian population. Key words: hepatocellular carcinoma, prognostic score, prognostic factors, survival of the patient

scholarly journals Immunotherapy in Hepatocellular Carcinoma: Is There a Light at the End of the Tunnel?

Cancers ◽  
2019 ◽  
Vol 11 (8) ◽  
pp. 1078 ◽  
Author(s):  
Amit Mahipal ◽  
Sri Harsha Tella ◽  
Anuhya Kommalapati ◽  
Alexander Lim ◽  
Richard Kim
Keyword(s):  
Hepatocellular Carcinoma ◽  
Immune Checkpoint ◽  
Immune Checkpoint Inhibitors ◽  
Checkpoint Inhibitors ◽  
Primary Liver Cancer ◽  
Progression Free Survival ◽  
The United States ◽  
Hepatic Reserve ◽  
Dismal Prognosis ◽  
United States Food

Hepatocellular carcinoma (HCC) is the most common primary liver cancer with dismal prognosis when diagnosed at advanced stages. Surgical resection of the primary tumor or orthotropic liver transplantation serves as a potential curative option. However, this approach is highly dependent on the hepatic reserve and baseline functional status of the patient. Liver directed therapies such as portal vein embolization (PVE), trans-arterial chemoembolization (TACE), and systemic chemotherapy are employed in non-surgical candidates. Sorafenib was the only approved systemic therapeutic agent for almost a decade until the recent approval of lenvatinib by the United States Food and Drug Administration (FDA) as an alternate first-line agent. Regorafenib, nivolumab, pembrolizumab and cabozantinib are approved by the FDA as second-line agents in patients who failed or could not tolerate sorafenib. Ramucirumab was recently FDA approved for the subset of patients that have high alfa-fetoprotein levels (>400 ng/mL). A better understanding of tumorigenesis and encouraging clinical trial results that evaluated immune-checkpoint inhibitors opened doors for immunotherapy in HCC. Immune checkpoint inhibitors have demonstrated a prolonged median overall and progression-free survival in a subset of patients with HCC. On-going translational and clinical research will hopefully provide us with a better understanding of tumor markers, genetic aberrations and other factors that determine the immunotherapy response in HCC. In this review, we sought to summarize the potential role and future directions of immunotherapy in the management of HCC.

scholarly journals Consistency Test between Scoring Systems for Predicting Outcomes of Chronic Myeloid Leukemia in a Saudi Population Treated with Imatinib

2017 ◽  
Vol 2017 ◽  
pp. 1-6 ◽  
Author(s):  
Haneen R. Banjar ◽  
Enaam Alsobhi
Keyword(s):  
Chronic Myeloid Leukemia ◽  
Myeloid Leukemia ◽  
Quantitative Polymerase Chain Reaction ◽  
Hematological Parameters ◽  
Prognostic Score ◽  
Scoring Systems ◽  
Transcript Level ◽  
Prognostic Scores ◽  
Molecular Response ◽  
Risk Categories

Inconsistency in prognostic scores occurs where two different risk categories are applied to the same chronic myeloid leukemia (CML) patient. This study evaluated common scoring systems for identifying risk groups based on patients’ molecular responses to select the best prognostic score when conflict prognoses are obtained from patient profiles. We analyzed 104 patients diagnosed with CML and treated at King Abdulaziz Medical City, Saudi Arabia, who were monitored for major molecular response (achieving a BCR-ABL1 transcript level equal to or less than 0.1%) by Real-Time Quantitative Polymerase Chain Reaction (RQ-PCR), and their risk profiles were identified using Sokal, Hasford, EUTOS, and ELTS scores based on the patients’ clinical and hematological parameters at diagnosis. Our results found that the Hasford score outperformed other scores in identifying risk categories for conflict groups, with an accuracy of 63%.

scholarly journals Novel Prognostic Scores Based on Plasma Prothrombin Time and Fibrinogen Levels in Patients With AFP-Negative Hepatocellular Carcinoma

2020 ◽  
Vol 27 (1) ◽  
pp. 107327482091552
Author(s):  
Minjie Mao ◽  
Xueping Wang ◽  
Yiling Song ◽  
Hui Sheng ◽  
Runkun Han ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Prothrombin Time ◽  
Prognostic Score ◽  
Preoperative Evaluation ◽  
Prognostic Significance ◽  
Glasgow Prognostic Score ◽  
Patient Characteristics ◽  
Prognostic Scores ◽  
Prognostic System ◽  
Preoperative Score

Noninvasive tools for the prognosis of α-fetoprotein negative hepatocellular carcinoma (HCC) are urgently needed. The present study proposed a prognostic system based on preoperative plasma prothrombin time and fibrinogen (PT/Fbg system). With respect to α-fetoprotein (AFP)-negative HCC, we compared the prognostic value in PT/Fbg system, Glasgow Prognostic Score, and aminotransferase/aspartate aminotransferase ratio. The present study retrospectively analyzed patient characteristics, clinicopathological factors, and the level of pretreatment biomarkers in 628 patients with HCC. Patients with increased PT and Fbg levels were allocated a score of 2, patients with only one of these abnormalities were assigned score 1, and patients with neither of these abnormalities were allocated a score of 0. The following distributions of the PT/Fbg system scores were observed: 187 (29.78%) patients had a score of 0, 305 (30.65%) had a score of 1, and 134 (22.69%) patients had a preoperative score of 2. The prognostic significance of the PT/Fbg system was determined using univariate and multivariate Cox hazard analyses in AFP-negative HCC. Multivariate analysis revealed that patients with a higher PT/Fbg system exhibited worse overall survival (OS) than patients with a lower PT/Fbg system. Our study proposes preoperative evaluation of the plasma PT/Fbg system to predict the OS of patients with AFP-negative HCC.

Estrogen Receptor Classification for Hepatocellular Carcinoma: Comparison With Clinical Staging Systems

2003 ◽  
Vol 21 (3) ◽  
pp. 441-446 ◽  
Author(s):  
Erica Villa ◽  
Alessandra Colantoni ◽  
Calogero Cammà ◽  
Antonella Grottola ◽  
Paola Buttafoco ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Estrogen Receptor ◽  
Multivariate Analysis ◽  
Classification System ◽  
Scoring System ◽  
Scoring Systems ◽  
Classification Systems ◽  
Clinical Staging ◽  
Therapeutic Decisions ◽  
Staging Systems

Purpose: Several scoring systems to evaluate patients with hepatocellular carcinoma (HCC) exist. A good scoring system should provide information on prognosis and guide therapeutic decisions. The presence of variant liver estrogen receptor (ER) transcripts in the tumor has been shown to be the strongest negative predictor of survival in HCC. The aim of this study was to compare the predictive value of the commonly applied clinical scoring systems for survival of patients with HCC with that of the evaluation of ER in patients with HCC (molecular scoring system). Materials and Methods: HCC was staged according to the Okuda classification, Barcelona Clinic Liver Cancer classification, Italian classification system (CLIP), French classification, and ER status in 96 patients. Analysis of survival was performed according to the Kaplan-Maier test and was made for each classification system and ER. A comparison between classifications was made by univariate and multivariate analysis. Results: Among the clinical classification systems, only the CLIP was able to identify patient populations with good, intermediate, and poor prognosis. On multivariate analysis, ER classification was shown to be the best predictive classification for survival of patients with HCC (P <.0001). This difference was the result of a better allocation of patients with ominous prognosis (variant ER) having nevertheless good clinical score. Conclusion: The evaluation of the presence of wild-type or variant ER transcripts in the tumor is the best predictor of survival in patients with HCC. Its accuracy in discriminating patients with good or unfavorable prognosis is significantly greater than that of the commonly used scoring systems for the staging of HCC.

scholarly journals Hepatocellular Carcinoma and Obesity, Type 2 Diabetes Mellitus, Cardiovascular Disease: Causing Factors, Molecular Links, and Treatment Options

2021 ◽  
Vol 12 ◽  
Author(s):  
Chunye Zhang ◽  
Shuai Liu ◽  
Ming Yang
Keyword(s):  
Diabetes Mellitus ◽  
Hepatocellular Carcinoma ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Molecular Mechanisms ◽  
Primary Liver Cancer ◽  
Treatment Options ◽  
The United States ◽  
Pathologic Features

Hepatocellular carcinoma (HCC) is the most common type of primary liver cancer, which will affect more than a million people by the year 2025. However, current treatment options have limited benefits. Nonalcoholic fatty liver disease (NAFLD) is the fastest growing factor that causes HCC in western countries, including the United States. In addition, NAFLD co-morbidities including obesity, type 2 diabetes mellitus (T2DM), and cardiovascular diseases (CVDs) promote HCC development. Alteration of metabolites and inflammation in the tumor microenvironment plays a pivotal role in HCC progression. However, the underlying molecular mechanisms are still not totally clear. Herein, in this review, we explored the latest molecules that are involved in obesity, T2DM, and CVDs-mediated progression of HCC, as they share some common pathologic features. Meanwhile, several therapeutic options by targeting these key factors and molecules were discussed for HCC treatment. Overall, obesity, T2DM, and CVDs as chronic metabolic disease factors are tightly implicated in the development of HCC and its progression. Molecules and factors involved in these NAFLD comorbidities are potential therapeutic targets for HCC treatment.

scholarly journals A Survey of Attitudes towards the Clinical Application of Systemic Inflammation Based Prognostic Scores in Cancer

2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
Author(s):  
David G. Watt ◽  
Campbell S. Roxburgh ◽  
Mark White ◽  
Juen Zhik Chan ◽  
Paul G. Horgan ◽  
...  
Keyword(s):  
Systemic Inflammation ◽  
Clinical Guidelines ◽  
Online Survey ◽  
Prognostic Score ◽  
Glasgow Prognostic Score ◽  
Scoring Systems ◽  
Prognostic Scores ◽  
Patients With Cancer ◽  
Modified Glasgow Prognostic Score ◽  
The Glasgow Prognostic Score

Introduction.The systemic inflammatory response (SIR) plays a key role in determining nutritional status and survival of patients with cancer. A number of objective scoring systems have been shown to have prognostic value; however, their application in routine clinical practice is not clear. The aim of the present survey was to examine the range of opinions internationally on the routine use of these scoring systems.Methods.An online survey was distributed to a target group consisting of individuals worldwide who have reported an interest in systemic inflammation in patients with cancer.Results.Of those invited by the survey (n=238), 65% routinely measured the SIR, mainly for research and prognostication purposes and clinically for allocation of adjuvant therapy or palliative chemotherapy. 40% reported that they currently used the Glasgow Prognostic Score/modified Glasgow Prognostic Score (GPS/mGPS) and 81% reported that a measure of systemic inflammation should be incorporated into clinical guidelines, such as the definition of cachexia.Conclusions.The majority of respondents routinely measured the SIR in patients with cancer, mainly using the GPS/mGPS for research and prognostication purposes. The majority reported that a measure of the SIR should be adopted into clinical guidelines.

scholarly journals Clinico-Epidemiological Analysis of Characteristics and Outcome in Patient with Hepatocellular Carcinoma Retrospective Study

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
M M Elbassiouny ◽  
M Y Mustafa ◽  
M E Saleh ◽  
N G A Gebril
Keyword(s):  
Hepatocellular Carcinoma ◽  
Overall Survival ◽  
Retrospective Study ◽  
Liver Cancer ◽  
Clinical Oncology ◽  
Primary Liver Cancer ◽  
Performance Status ◽  
Progression Free Survival ◽  
University Hospital ◽  
Free Survival

Abstract Background Hepatocellular carcinoma (HCC) is the most common form of primary liver cancer. Globally, liver cancer is the 5th and 7th most common cancer in men and women, respectively. Most of HCC burden lies in developing countries. The regions of high incidence include Eastern and South-Eastern Asia, Middle and Western Africa. Worldwide, it is the third most common cause of cancer deaths Aim of the Work A retrospective study of Hepatocellular carcinoma patients presented to Ain Shams University Hospital clinical oncology department between the period of 1/2013 till the end of 12/2016 aiming to review of epidemiological and clinical risk factors, response to the therapy used, progression free survival and overall survival. Patients and Methods The current study is a retrospective analysis carried out in Ain-Shams clinical Oncology and Nuclear Medicine department, Faculty of medicine, Ain Shams University between the period of 1st January 2013 till the end of 2016, where 136 medical records were planned to be analyzed, from which 18 records were not included in analysis (8 records weren’t available in the archive, 10 contained inadequate data) and 118 were analyzed aiming at detection of the prognostic factors, response, progression free survival and overall survival of patients with HCC. Results Regarding age, the median age at diagnosis was 58 years (SD = 8.29), where the average median age was 57.5 years. In our study most of patients were presented with good PS, where 100 (84.7%) of them had performance status less than or equals 2 and only 18 patients (11.8%) were more than or equals 3 performance status &lt; 2 in 84 % of all cases and &gt;2 in 16 %. Conclusion To conclude, age as a prognostic factor significantly affects survival in favor of patients &lt; =58 years. RFA affects survival. Performance status significantly affects survival. The quality of data reported was to some extent impaired due unavailability of complete clinical, analytical and radiological information in the charts.

scholarly journals Time-Varying mHAP-III Is the Most Accurate Predictor of Survival in Patients with Hepatocellular Carcinoma Undergoing Transarterial Chemoembolization

Liver Cancer ◽  
2021 ◽  
Vol 10 (2) ◽  
pp. 126-136
Author(s):  
Claudia Campani ◽  
Alessandro Vitale ◽  
Gabriele Dragoni ◽  
Umberto Arena ◽  
Giacomo Laffi ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Transarterial Chemoembolization ◽  
Proportional Hazards Model ◽  
Cox Proportional Hazards Model ◽  
Prognostic Scores ◽  
Prognostic Models ◽  
Independent Effect ◽  
Ratio Test ◽  
Time Varying ◽  
Staging Systems

<b><i>Introduction:</i></b> The prognosis of patients undergoing transarterial chemoembolization (TACE) is extremely variable, and a confounding factor is that TACE is often repeated several times. We retrospectively evaluated the accuracy of different prognostic scores and staging systems in estimating overall survival (OS) in patients with hepatocellular carcinoma (HCC). <b><i>Methods:</i></b> An analysis considering prognostic models as time-varying variables was performed, calculating OS from the time of TACE to the time of the subsequent treatment. Total follow-up time for each patient was therefore split into several observation times accounting for each TACE procedure. Values of the likelihood ratio test (LRT) and Akaike information criterion (AIC) were used to compare different systems. Univariable and multivariable analyses were conducted to identify additional factors predictive of OS. We analyzed 1,610 TACE performed in 1,058 patients recorded in the Italian Liver Cancer database from 2008 through 2016. <b><i>Results:</i></b> The median OS of the enrolled patients was 41 months. According to LRT χ<sup>2</sup> and AIC values based on the time-varying analysis, mHAP-III achieved the best values (41.72 and 4,625.49, respectively, <i>p</i> &#x3c; 0.0001), indicating the highest predictive performance compared with all other scores (HAP, mHAP-II, ALBI, and pALBI) and staging systems (MELD, ITALICA, CLIP, MESH, MESIAH, JIS, HKLC, and BCLC). In the multivariable Cox proportional hazards model, mHAP-III maintained an independent effect on OS (hazard ratio 1.31, 95% CI: 1.10–1.55, <i>p</i> &#x3c; 0.0001). Time-varying age, alcoholic etiology, radiologic response to TACE, and performing ablation or surgery after TACE were additional significant variables resulting from the multivariable model. <b><i>Conclusion:</i></b> An innovative time-varying analysis revealed that mHAP-III was the most accurate model in predicting OS in patients with HCC undergoing TACE. Other clinical pre- and post-TACE variables were also found to be relevant for this prediction.

scholarly journals The modified Boey score (mBoey) for outcome prediction in patients with perforated peptic ulcer complicated by diffuse peritonitis: a retrospective study

2020 ◽  
Author(s):  
Aleksandr Sazhin ◽  
Georgii Ivakhov ◽  
Egor Stradymov ◽  
Vitalii Petukhov ◽  
Svetlana Titkova
Keyword(s):  
Peptic Ulcer ◽  
Outcome Prediction ◽  
Prognostic Score ◽  
Scoring Systems ◽  
Perforated Peptic Ulcer ◽  
Prognostic Scores ◽  
Diffuse Peritonitis ◽  
Peptic Ulcer Perforation ◽  
Operating Characteristics ◽  
Age Factor

Abstract Background several scoring systems are developed to stratify the patients with perforated peptic ulcer (PPU), complicated by peritonitis. The aim of this study was to evaluate the accuracy of different scoring systems in outcome prediction in patients following surgical treatment for PPU complicated by diffuse peritonitis and to determine the possibility of enhancing the Boey score prognostic performance based on the addition of an age factor. Methods this is a retrospective multicenter study of 153 patients surgically treated for PPU with diffuse peritonitis in Pirogov Russian National Research Medical University's surgical clinics during 2014–2016 years. The outcome prediction accuracy of the modified Boey score (mBoey), Boey score, peptic ulcer perforation (PULP) score, the American Society of Anaesthesiologists (ASA) score, Mannheim peritonitis index (MPI) and WSES sepsis severity score (WSES SSS) was evaluated by receiver operating characteristics curve (ROC) analysis, and the corresponding areas under the curve (AUC) were compared. Results all scores demonstrated the high quality of the model according to the AUC values, both in relation to mortality and postoperative complications - from good (WSES SSS) to perfect (mBoey, Boey, PULP, ASA).The modified mBoey predicted morbidity (AUC – 0.932) and mortality (AUC – 0.943) better than other prognostic scoring systems. Conclusions the use of prognostic scores allows identifying the high-risk patients with perforated peptic ulcers complicated by diffuse peritonitis. The modified prognostic score developed by adding an age factor to Boey score was found to be superior in prediction of morbidity and mortality after repair of PPU.

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