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A Novel Scoring System for Patients with Recurrence of Hepatocellular Carcinoma After Undergoing Minimal Invasive Therapies

Authors Wang Q, Ma L, Li J, Yuan C, Sun J, Li K, Qin L, Zang C, Zhao Y, Zhao Y, Zhang Y

Received 25 July 2019

Accepted for publication 8 December 2019

Published 20 December 2019 Volume 2019:11 Pages 10641—10649

DOI https://doi.org/10.2147/CMAR.S224711

Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 2

Editor who approved publication: Professor Nakshatri


Qi Wang,1 Liang Ma,2 Jianjun Li,2 Chunwang Yuan,2 Jianping Sun,1 Kang Li,1 Ling Qin,1 Chaoran Zang,1 Yanan Zhao,1 Yan Zhao,3,* Yonghong Zhang1,2,*

1Research Center for Biomedical Resources, Beijing You’an Hospital, Capital Medical University, Beijing 100069, People’s Republic of China; 2Interventional Therapy Center for Oncology, Beijing You’an Hospital, Capital Medical University, Beijing 100069, People’s Republic of China; 3Clinical Detection Center, Beijing You’an Hospital, Capital Medical University, Beijing 100069, People’s Republic of China

*These authors contributed equally to this work

Correspondence: Yonghong Zhang
Research Center for Biomedical Resources; Interventional Therapy Center for Oncology; Beijing You’an Hospital, Capital Medical University, 8 Xitoutiao, Youanmenwai Street, Fengtai District, Beijing, People’s Republic of China
Tel +86 138 1010 8505
Email 13810108505@163.com
Yan Zhao
Clinical Detection Center Beijing You’an Hospital, Capital Medical University, 8 Xitoutiao, Youanmenwai Street, Fengtai District, Beijing, People’s Republic of China
Tel +86 189 1138 0390
Email 18911380390@163.com

Background: The higher recurrence rate of hepatocellular carcinoma (HCC) needs to be urgently controlled. However, definitive markers are lacking for patients with recurrence of HCC after undergoing minimal invasive therapies—local ablation combined with transcatheter arterial chemoembolization (TACE).
Materials and methods: Demographic and clinicopathological data of 234 subjects receiving combined therapies as the initial treatment were retrospectively analyzed. Univariate and multivariate Cox regression analysis was used to assess independent risk factors of recurrence. Selected variables were divided into low-, intermediate-, and high-risk groups of recurrence according to the scores assigned to them based on their respective hazard ratio (HR) values. The area under the curve (AUC) was used to evaluate the predictive value of the scoring system. Cumulative recurrence-free survival (RFS) and overall survival rates were calculated by the Kaplan–Meier estimator. Finally, a correlation analysis was performed on demographic and clinical data among the three groups.
Results: The AUC of predicting 1-, 2-, and 3-year recurrence rates was 0.680, 0.728, and 0.709, respectively. The cumulative RFS rate in the low-risk group at 1, 2, and 3 years after undergoing combined treatments was 4%, 12.2%, and 30.6%, while that in the intermediate-risk group and high-risk group was 23.4%, 51.6%, 60.0%, and 47.3%, 78.2%, 83.6%, respectively. Gamma-glutamyltransferase (γ-GT), blood urea nitrogen (BUN), and total cholesterol (TC) levels among the three groups were statistically different.
Conclusion: The scoring system of the present study for patients with the recurrence of HCC after undergoing TACE combined with local ablation may help physicians make a reasonable clinical decision, providing ideal management for diagnosis and treatment.

Keywords: ablation, hepatocellular carcinoma, transcatheter arterial chemoembolization, scoring system, recurrence

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