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Transarterial chemo-embolisation of hepatocellular carcinoma: impact of liver function and vascular invasion

Waked, I; Berhane, S; Toyoda, H; Chan, SL; Stern, N; Palmer, D; Tada, T; ... Johnson, PJ; + view all (2017) Transarterial chemo-embolisation of hepatocellular carcinoma: impact of liver function and vascular invasion. British Journal of Cancer , 116 pp. 448-454. 10.1038/bjc.2016.423. Green open access

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Abstract

BACKGROUND: Transarterial chemo-embolisation (TACE) is recommended for patients with BCLC intermediate stage hepatocellular carcinoma (stage B), particularly in patients with good underlying liver function and minimal symptoms. The hepatoma arterial embolisation prognostic (HAP) score combines measures of liver function and tumour-related factors to offer a simple prognostic scoring system. The Albumin-Bilirubin (ALBI) grade permits assessment of the impact of liver function on survival. We aimed to investigate these two models and vascular invasion (VI). METHODS: In an international cohort of 3030 patients undergoing TACE, we examined the impact of liver function as assessed by the ALBI score, the HAP score and VI on survival. RESULTS: Classification according to ALBI grade resulted in non-overlapping survival curves in the overall data set and all regional cohorts. The HAP score was also validated. Tumour number, aetiology and VI were identified as additional independent prognostic risk factors not currently included in the HAP score. Survival was particularly poor for patients with VI. CONCLUSIONS: The ALBI grade categorised patients receiving TACE into three clear prognostic groups, thereby emphasising the importance of underlying liver function in the outcome of TACE. The HAP score has been validated internationally and the serious adverse impact of VI is clearly shown.

Type: Article
Title: Transarterial chemo-embolisation of hepatocellular carcinoma: impact of liver function and vascular invasion
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.1038/bjc.2016.423
Publisher version: http://dx.doi.org/10.1038/bjc.2016.423
Language: English
Additional information: Copyright © The Author(s). This work is licensed under the Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/3.0/
Keywords: Hepatocellular carcinoma; transarterial chemo-embolisation; ALBI grade; HAP score; vascular invasion; Child-Pugh
UCL classification: UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Cancer Institute
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Cancer Institute > Research Department of Oncology
URI: http://discovery.ucl.ac.uk/id/eprint/1538683
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