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ORIGINAL ARTICLE
Year : 2021  |  Volume : 17  |  Issue : 3  |  Page : 740-748

Intermediate stage hepatocellular carcinoma: Comparison of the value of inflammation-based scores in predicting progression-free survival of patients receiving transarterial chemoembolization


1 Department of Medicine Medical Oncologist Chemotherapy and Minimally Invasive Treatment of Malignant Tumors, Jinshazhou Hospital of Guangzhou University of Chinese Medicine International Tumor Medicine Center, Guangzhou, People's Republic of China
2 Department of Minimally Invasive Interventional Therapy, Sun Yat-sen University Cancer Center; Zhongshan Medical School, Sun Yat-sen University, Guangzhou, People's Republic of China
3 Department of Minimally Invasive Interventional Therapy, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Sun Yat-sen University, Guangzhou, People's Republic of China
4 Department of Nursing, Medical College of Shaoguan University, Guangzhou, People's Republic of China
5 Department of Medicine MedicalOncologist Chemotherapy and Minimally Invasive Treatment of Malignant Tumors, Jinshazhou Hospital of Guangzhou University of Chinese Medicine International Tumor Medicine Center, Guangzhou, People's Republic of China

Correspondence Address:
Weijun Fan
Department of Minimally Invasive Interventional Therapy, Sun Yat-sen University Cancer Center, Guangzhou 510 060; State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Sun Yat-sen University, Guangzhou 510 060
People's Republic of China
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jcrt.jcrt_29_21

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Context and Aims: The identification of inflammation-related prognostic heterogeneity in intermediate-stage hepatocellular carcinoma (HCC) can reveal more effective first-line treatments. Our study aimed to compare the intermediate-stage HCC patients' different inflammation-based scores in predicting their progression-free survival (PFS) after transarterial chemoembolization (TACE). Materials and Methods: We analyzed retrospectively a total of 128 intermediate-stage HCC patients who received first-line TACE treatment. We used the Cox-proportional hazards modeling to identify the independent prognostic factors. We compared the inflammation-based scores abilities to predict the PFS through the time-dependent receiver operating characteristic curves and area under the curves. Results: The multivariate analysis showed that tumor size and platelet-to-lymphocyte ratio (PLR) were the independent prognostic factors for PFS (P < 0.05). The PLR predicted the intermediate-stage HCC patients' PFS receiving the TACE treatment better than other inflammation-based scores (e.g., the neutrophil-to-lymphocyte ratio, the Glasgow Prognostic Score (GPS), the modified GPS, the Prognostic Index, the Prognostic Nutritional Index, the lymphocyte-to-monocyte ratio, and the systemic immune-inflammation index) (P < 0.05). An easy-to-use novel inflammation score based on tumor size – PLR-size score significantly improved the PFS prediction performance (P < 0.05). Conclusions: As a first-line treatment, TACE was not well suitable for all intermediate-stage HCC patients, while the PLR was a better inflammation-based score than others. Tumor size should be regarded as an essential variable in affecting intermediate-stage HCC patients' first-line treatment strategies.


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