P-43 Prognostic Models After Transarterial Chemoembolization in a Latin American Prospective Cohort Study
Year: 2024
Type: article
Study design: Observational Study
Abstract: Conflict of interest No Introduction and Objectives With the advent of new therapeutic options for patients with hepatocellular carcinoma (HCC) at intermediate stage of the Barcelona Clinic Liver Cancer (BCLC), regional real-world data regarding prognostic survival factors are significant. The aim of this study was to evaluate pre and post-prognostic survival variables after transarterial chemoembolization (TACE). Patients / Materials and Methods A multicenter prospective cohort study was conducted in Argentina, Chile, Brazil, and Colombia, including HCC patients at BCLC B or C stages who were treated with TACE from 2018 to 2024. The effect on survival since date of first TACE was evaluated through Cox proportional hazard survival analysis. Harrell´s c-statistic index for model discrimination was estimated through somers-d. Results and Discussion Overall, 625 patients were included, of which 41.3% (n=258) received TACE (Table 1), and 4.6% (n=29) selective internal radiation therapy (SIRT). The median number of TACEs procedures was 2 (range 1-3); 54.5% conventional TACE, and 44.7% with drug-eluting beads. Median follow-up since first TACE was 17.7 months, with a median overall survival of 27.3 months (range 21.9-35.1). Radiological objective response rates (ORR) after first and last TACEs were 49.2% (95% CI 42.9-55.5%), and 29.0% (95% CI 22.6-36.1%), with significantly better post TACE survival [HR of 0.48 (95% CI 0.29-0.78); P=0.003]. The pre-TACE prognostic model showed liver decompensation was an independent variable associated with increased post TACE mortality was [HR 2.0 (CI 1.28-3.12)], adjusted for performance status, and the HAP score. Pre and post-TACE model showed that the effect of liver decompensation was adjusted [HR 1.7 (CI 0.98-2.8); P=0.06], when ORR after last TACE was achieved and included in this model [HR 0.48 (CI 0.29-0.79); P=0.004], with a c-statistic index of 0.66 (95% CI 0.60-0.72). Conclusions Radiological response after sequential TACE might reduce the negative effect of liver decompensation on post-TACE survival. However, cautious TACE stopping rules should be considered.
Source: Annals of Hepatology
Authors: FEDERICO PIÑERO, Margarita Anders, Carla Bermudez, Ezequiel Demirdjian, Adriana Varón, Dolores Murga, Jorge Rodriguez, Oscar Beltrán, Solange Escobedo Marambio, Leonardo Gomes da Fonseca, Ezequiel Ridruejo, Pablo Caballini, Alexandre Araujo, Alonso Vera Torres, Juan Ignacio Marin, Natalia Ratusnu, Federico Orozco Ganem, Jaime Poniachik, Sebastián Marciano, Fernando Bessone, Manuel Mendizabal
Institutions: Hospital Universitario Austral, Hospital Alemán, Hospital Italiano de Buenos Aires, Institute of Cardiology, Hospital Clínico de la Universidad de Chile, Centro de Educación Médica e Investigaciones Clínicas Norberto Quirno, Universidade Federal do Rio Grande do Sul, Hospital de Clínicas de Porto Alegre, Fundación Santa Fe de Bogotá, Hospital Pablo Tobon Uribe
Language: English
Subfield: Hepatology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $1,500
OpenAlex ID: W4405119364