The PPRD score stratifies patients with hepatocellular carcinoma and portal vein tumor thrombus treated with sorafenib plus transarterial chemoembolization

Objectives To identify clinical prognostic and predictive factors in patients with hepatocellular carcinoma (HCC) and portal vein tumor thrombus (PVTT) undergoing sorafenib plus transarterial chemoembolization (TACE) and establish a prognostic score for these patients. Methods Between January 2012 a...

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Bibliographic Details
Published in:European radiology 2021, Vol.31 (1), p.232-243
Main Authors: Zhang, Yingqiang, Miao, Hongfei, Xie, Wenlin, Jiang, Suxiang, Song, Ze, Huang, Guihua, Fan, Wenzhe, Wang, Yu, Li, Jiaping, Chen, Yong
Format: Article
Language:English
Subjects:
Blood clots
Carcinoma, Hepatocellular - complications
Carcinoma, Hepatocellular - therapy
Chemoembolization
Chemoembolization, Therapeutic
Diagnostic Radiology
Hepatobiliary-Pancreas
Hepatocellular carcinoma
Humans
Imaging
Inhibitor drugs
Internal Medicine
Interventional Radiology
Liver cancer
Liver Neoplasms - therapy
Medical prognosis
Medicine
Medicine & Public Health
Multivariate analysis
Neuroradiology
Patients
Portal vein
Portal Vein - diagnostic imaging
Prognosis
Radiology
Retrospective Studies
Sorafenib
Survival
Targeted cancer therapy
Thrombosis
Toxicity
Treatment Outcome
Tumors
Ultrasound
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Summary:Objectives To identify clinical prognostic and predictive factors in patients with hepatocellular carcinoma (HCC) and portal vein tumor thrombus (PVTT) undergoing sorafenib plus transarterial chemoembolization (TACE) and establish a prognostic score for these patients. Methods Between January 2012 and December 2017, 184 consecutive patients with HCC and PVTT were concurrently treated with sorafenib and TACE. Univariate and multivariate analyses were performed to explore the clinical factors independently correlated with overall survival (OS). A prognostic score was then developed to identify different prognoses in an initial cohort and validated in an external cohort ( n  = 72). Results In the multivariate analysis, performance status, extension of PVTT, initial radiological response, and sorafenib-related dermatologic toxicity were identified as predictors associated with OS. These factors were used to develop a prognostic score (PPRD score, range from 0 to 11). The median survival was found to decrease as the PPRD score increased, and patients were stratified into a favorable group (0 points), intermediate group (1–4 points), and dismal group (> 4 points). The median survival of patients in the three groups was 34.0 months, 20.0 months, and 7.0 months, respectively ( p  
ISSN:0938-7994
1432-1084
DOI:10.1007/s00330-020-07078-z