Abstract
Purpose:To investigate the prognostic value of 17 platelet-based prognostic scores in patients with malignant hepatic tumors after TACE therapy.Methods:In total, 92 patients were divided into death group and survival group according to long-term follow-up results. The AUC was calculated to determine the optimal cut-off values for predicting prognosis. To determine better prognostic models, platelet-based models were analyzed separately after being showed as binary according to cut-off values. Cumulative survival rates of malignant hepatic tumors were calculated using Kaplan-Meier curves and differences were analyzed by the log-rank test. Univariate and multivariate analyses were performed to identify platelet-based prognostic scores associated with overall survival.Results:Univariate analysis showed that APGA, APRI, FIB-4, FibroQ, GUCI, King's score, Lok index, PAPAS, cirrhosis, number of tumors, vascular cancer embolus, AFP, ALP and APTT were significantly related to prognosis. A multivariate analysis showed that the APGA, number of tumors, ALP and APTT were independently associated with overall survival.Conclusion:This study showed that the APGA, a platelet-based prognostic score, was an independent marker of prognosis in patients with malignant hepatic tumors after TACE and was superior to the other platelet-based prognostic scores in terms of prognostic ability.
Highlights
Malignant hepatic tumors were the sixth most frequently diagnosed cancer worldwide, and the fourth leading cause of tumor-related deaths[1]
We aimed to investigate the prognostic value of these platelet-based prognostic models in patients with malignant hepatic tumors who underwent Transcatheter arterial chemoembolization (TACE), and to select the most predictive model for guiding TACE preoperative evaluation
92 patients with intermediate or advanced diagnosed malignant hepatic tumors and performing TACE that had been treated at the Intervention Department, the Affiliated Hospital of Qinghai University, between November 2011 and October 2018 were enrolled in the study
Summary
Malignant hepatic tumors were the sixth most frequently diagnosed cancer worldwide, and the fourth leading cause of tumor-related deaths[1]. Patients with malignant hepatic tumors were treated by different methods based on TNM stage of tumor and hepatic function reserve before accepting treatment. There were no obvious symptoms at the early stage, and most of the patients had entered the middle and late stage at the time of diagnosis. Patients with intermediate or advanced stage tumors were not suitable for radical treatment according to the Barcelona Clinic Liver Cancer staging system (BCLC)[3]. Transcatheter arterial chemoembolization (TACE) was the optimum palliative treatment for patients with unresectable malignant hepatic tumors. The median survival time of patients with malignant hepatic tumors after TACE was 12 months, which was significantly lower than that after radical liver resection[4]. It is very important to evaluate the prognosis of patients performing TACE according to specific laboratory indexes before treatment
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