1
|
Li S, Li Y. Is lenvatinib in combination with transarterial chemoembolization benefit for unresectable hepatocellular carcinoma (uHCC)? The age interference needs to be eliminated. Hepatol Int 2024; 18:704-705. [PMID: 37943415 DOI: 10.1007/s12072-023-10611-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Accepted: 10/20/2023] [Indexed: 11/10/2023]
Affiliation(s)
- Sai Li
- Interventional Radiology Center, Department of Radiology, The Third Xiangya Hospital of Central South Hospital, Changsha, 410005, Hunan, China
- Interventional Radiology Center, Department of Radiology, Xiangya Hospital Central South University, Changsha, 410005, Hunan, China
| | - Yong Li
- Department of Gastroenterology, Xiangya Hospital, Central South University, Changsha, 410005, Hunan, China.
| |
Collapse
|
2
|
Liu J, Yan S, Zhang G, Yang L, Wei S, Yi P. A retrospective study of transarterial chemoembolization (TACE) combined with lenvatinib compared with TACE monotherapy for BCLC B2 stage hepatocellular carcinoma. Oncol Lett 2023; 26:507. [PMID: 37920437 PMCID: PMC10618929 DOI: 10.3892/ol.2023.14094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 09/25/2023] [Indexed: 11/04/2023] Open
Abstract
The present study aimed to compare the efficacy and safety of combination therapy with lenvatinib (Len) plus transarterial chemoembolization (TACE) and TACE alone in patients with Barcelona Clinic Liver Cancer (BCLC) B2 stage hepatocellular carcinoma (HCC). A total of 66 patients with BCLC B2 stage HCC were retrospectively reviewed in the present study, of which 34 patients received Len + TACE, while 32 patients received TACE alone between May 2018 and May 2020. Survival outcome, tumor response and adverse events (AEs) were compared between the two treatment groups. The 6-month, 1- and 2-year overall survival (OS) rates were significantly higher in the Len + TACE group (97.1, 85.3 and 76.3%, respectively) compared with those in the TACE group [(93.8, 81.1 and 45.4%, respectively); hazard ratio (HR), 0.395; 95% confidence interval (CI), 0.180-0.867; P=0.023], but no significant difference in progression-free survival rate was observed between the two groups (HR, 0.815; 95% CI, 0.437-1.520; P=0.510). Patients receiving Len + TACE demonstrated a higher objective response rate compared with those receiving TACE alone (64.7 vs. 34.4%; P=0.014). Therefore, Len + TACE combination therapy was associated with increased OS and tumor response compared with that of TACE monotherapy in patients with BCLC B2 stage HCC. However, large-scale, multicenter, prospective studies are needed to further confirm these results.
Collapse
Affiliation(s)
- Junning Liu
- Department of Hepato-Biliary-Pancreas II, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan 637000, P.R. China
| | - Shu Yan
- Department of Hepato-Biliary-Pancreas II, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan 637000, P.R. China
| | - Guangnian Zhang
- Department of Hepato-Biliary-Pancreas II, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan 637000, P.R. China
| | - Linfeng Yang
- Department of Hepato-Biliary-Pancreas II, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan 637000, P.R. China
| | - Song Wei
- Department of Hepato-Biliary-Pancreas II, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan 637000, P.R. China
| | - Pengsheng Yi
- Department of Hepato-Biliary-Pancreas II, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan 637000, P.R. China
| |
Collapse
|
3
|
Zhang L, Hong W, Wang Z, Zheng C, Liang B, Shi H. Safety and Effectiveness of Transarterial Chemoembolization in Hepatocellular Carcinoma Patients Aged Greater versus Less Than 80 Years. Clin Interv Aging 2023; 18:1883-1892. [PMID: 38020452 PMCID: PMC10656852 DOI: 10.2147/cia.s429259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 11/05/2023] [Indexed: 12/01/2023] Open
Abstract
Background Population aging has emerged as a pressing global concern and a significant medical challenge. The use of transarterial chemoembolization (TACE) has been extensively employed for managing unresectable hepatocellular carcinoma (HCC). However, there is limited evidence regarding the safety and effectiveness of TACE specifically in individuals aged 80 years and above. Aim To examine the safety and effectiveness of TACE in elderly patients (≥ 80 years) compared to younger patients (< 80 years) with HCC, and the potential risk factors that may impact the progression-free survival (PFS) for TACE were also identified. Methods A retrospective analysis was conducted on a consecutive cohort of unresectable HCC patients who were initially treated with TACE. The patients were categorized into two groups based on the age at which they underwent TACE, and the efficacy and safety of the treatment were evaluated. The PFS was investigated, and the prognostic factors were analyzed using the Kaplan-Meier method and Cox proportional hazard models. Results A total of 198 patients were included in this study, with 44 patients aged 80 years or older and 154 patients younger than 80 years. The cumulative risk of PFS after TACE was similar between the two groups (P = 0.800). In the multivariate analysis, a lower ECOG score (P = 0.039) and an earlier BCLC stage (P = 0.004) were identified as independent predictors of better PFS. Patients in both groups tolerated the TACE treatment well. Conclusion The impact of aging on poor PFS is not significant. In patients with HCC, TACE therapy is both safe and effective for octogenarians, similar to younger patients. Furthermore, the better PFS is associated with a low ECOG score and an early BCLC stage.
Collapse
Affiliation(s)
- Lijie Zhang
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
- Key Laboratory of Molecular Imaging of Hubei Province, Wuhan, Hubei, China
| | - Wei Hong
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
- Key Laboratory of Molecular Imaging of Hubei Province, Wuhan, Hubei, China
| | - Zizhuo Wang
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
- Key Laboratory of Molecular Imaging of Hubei Province, Wuhan, Hubei, China
| | - Chuansheng Zheng
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
- Key Laboratory of Molecular Imaging of Hubei Province, Wuhan, Hubei, China
| | - Bin Liang
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
- Key Laboratory of Molecular Imaging of Hubei Province, Wuhan, Hubei, China
| | - Heshui Shi
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
- Key Laboratory of Molecular Imaging of Hubei Province, Wuhan, Hubei, China
| |
Collapse
|
4
|
Fründt TW, Casar C, von Felden J, Schöler U, Priebe M, Kraczyk J, Ahrend H, Salamon J, Adam G, Huber S, Lohse AW, Wege H, Schulze K. Equal Efficacy and Safety Profile in Elderly Patients with Hepatocellular Carcinoma Receiving Palliative Treatment. Cancers (Basel) 2022; 14:768. [PMID: 35159035 PMCID: PMC8833746 DOI: 10.3390/cancers14030768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 01/20/2022] [Accepted: 01/27/2022] [Indexed: 12/10/2022] Open
Abstract
Palliative treatment of elderly patients with hepatocellular carcinoma (HCC) is often challenging due to comorbidities or frailty, and data about the outcome and overall survival (OS) in these patients are limited. This was a retrospective single centre study. Patients were grouped according to their age as young (<60 years; YP), intermediate (60-70 years; IP) or elderly (>70 years; EP). Administration of chemotherapy or transarterial chemoembolization (TACE) was defined as palliative treatment. Therapy-related adverse events (AE) were assessed via CTCAE 5.0. Out of 656 patients analyzed, n = 359 received palliative treatment: YP: n = 90; IP: n = 127 and EP: n = 142. The median OS (months) in patients receiving TACE (n = 254) was 17 vs. 18 vs. 20 months for YP, IP, and EP, respectively (p = 0.44) and 15 vs. 16 vs. 17 months (p = 0.56), respectively, in patients receiving chemotherapy (n = 105). AEs differed non-significantly between the subgroups. Multivariate analysis revealed impaired liver function and advanced tumor stage as significant factors for impaired OS. In this study, the mOS and rate of AEs were equal between elderly and younger HCC patients receiving palliative treatment. Therefore, we propose regular palliative treatment stratification in spite of the high age of patients.
Collapse
Affiliation(s)
- Thorben W. Fründt
- I. Department of Medicine, Gastroenterology and Hepatology, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany; (J.v.F.); (U.S.); (M.P.); (S.H.); (A.W.L.); (H.W.); (K.S.)
| | - Christian Casar
- Bioinformatics Facility, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany; (C.C.); (J.K.)
| | - Johann von Felden
- I. Department of Medicine, Gastroenterology and Hepatology, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany; (J.v.F.); (U.S.); (M.P.); (S.H.); (A.W.L.); (H.W.); (K.S.)
| | - Ulrike Schöler
- I. Department of Medicine, Gastroenterology and Hepatology, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany; (J.v.F.); (U.S.); (M.P.); (S.H.); (A.W.L.); (H.W.); (K.S.)
| | - Maximilian Priebe
- I. Department of Medicine, Gastroenterology and Hepatology, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany; (J.v.F.); (U.S.); (M.P.); (S.H.); (A.W.L.); (H.W.); (K.S.)
| | - Jenny Kraczyk
- Bioinformatics Facility, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany; (C.C.); (J.K.)
| | - Hannes Ahrend
- Department of Internal Medicine, Israelitic Hospital, 22297 Hamburg, Germany;
| | - Johannes Salamon
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany; (J.S.); (G.A.)
| | - Gerhard Adam
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany; (J.S.); (G.A.)
| | - Samuel Huber
- I. Department of Medicine, Gastroenterology and Hepatology, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany; (J.v.F.); (U.S.); (M.P.); (S.H.); (A.W.L.); (H.W.); (K.S.)
| | - Ansgar W. Lohse
- I. Department of Medicine, Gastroenterology and Hepatology, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany; (J.v.F.); (U.S.); (M.P.); (S.H.); (A.W.L.); (H.W.); (K.S.)
| | - Henning Wege
- I. Department of Medicine, Gastroenterology and Hepatology, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany; (J.v.F.); (U.S.); (M.P.); (S.H.); (A.W.L.); (H.W.); (K.S.)
- Cancer Center Esslingen, Klinikum Esslingen, 73730 Esslingen am Neckar, Germany
| | - Kornelius Schulze
- I. Department of Medicine, Gastroenterology and Hepatology, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany; (J.v.F.); (U.S.); (M.P.); (S.H.); (A.W.L.); (H.W.); (K.S.)
| |
Collapse
|
5
|
Mosconi C, Gramenzi A, Cappelli A, Biselli M, Golfieri R. Reply to "Re: Survival and Tolerability of Transarterial Chemoembolization in Greater Versus less than 70 Years of Age Patients with Unresectable Hepatocellular Carcinoma-A Propensity Analysis". Cardiovasc Intervent Radiol 2021; 44:1135-1136. [PMID: 33751191 DOI: 10.1007/s00270-021-02799-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 02/03/2021] [Indexed: 11/26/2022]
Affiliation(s)
- Cristina Mosconi
- Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Sant'Orsola-Malpighi HospitalVia Albertoni 15, 40138, Bologna, Italy.
| | - Annagiulia Gramenzi
- Division of Semeiotic, Department of Medical and Surgical Sciences- DIMEC, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Albertoni 15, Bologna, Italy
| | - Alberta Cappelli
- Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Sant'Orsola-Malpighi HospitalVia Albertoni 15, 40138, Bologna, Italy
| | - Maurizio Biselli
- Division of Semeiotic, Department of Medical and Surgical Sciences- DIMEC, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Albertoni 15, Bologna, Italy
| | - Rita Golfieri
- Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Sant'Orsola-Malpighi HospitalVia Albertoni 15, 40138, Bologna, Italy
| |
Collapse
|
6
|
Li Z, Han X. Re: Survival and Tolerability of Transarterial Chemoembolization in Greater Versus less than 70 Years of Age Patients with Unresectable Hepatocellular Carcinoma-A Propensity Analysis. Cardiovasc Intervent Radiol 2020; 44:662. [PMID: 33205289 DOI: 10.1007/s00270-020-02701-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2020] [Accepted: 10/31/2020] [Indexed: 10/23/2022]
Affiliation(s)
- Zhaonan Li
- Department of Interventional Radiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China
| | - Xinwei Han
- Department of Interventional Radiology, First Affiliated Hospital of Zhengzhou University, No. 1 Jianshe East Road, Zhengzhou City, 450000, Henan Province, China.
| |
Collapse
|