Department of Minimally Invasive Interventional Radiology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Cancer for Cancer Medicine , Guangzhou , P.R. China.
Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Department of Interventional Radiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University , Guangzhou , P.R. China.
Int J Hyperthermia. 2019;36(1):841-853. doi: 10.1080/02656736.2019.1646927.
To compare the predictive value of albumin-bilirubin (ALBI) grade, platelet-ALBI (PALBI) grade and Child-Turcotte-Pugh (CTP) class in patients with large hepatocellular carcinoma (HCC) after transarterial chemoembolization (TACE) combined with microwave ablation (TACE-MWA). A total of 349 consecutive HCC patients (89.1% male; mean [± SD] age 53.4 ± 12.27 years) from three medical centers, who underwent TACE-MWA for up to 3 HCCs with maximum diameters of 5.1-8.0 cm between January 2000 and June 2018, were investigated. Overall survival (OS) and progression-free survival (PFS) were analyzed. The prognostic performances of ALBI grade, PALBI grade and CTP class were compared. TACE procedures were performed using lobaplatin (20-50 mg), epirubicin (30-60 mg), lipiodol (5-25 mL) and gelatin sponge particles (350-560 μm). The end point of the TACE procedure was stasis of blood flow in the feeder artery. The median follow-up duration was 28.0 months, the median OS was 28.0 months (95% confidence interval [CI] 23.55-32.45 months), and the median PFS was 4.8 months (95% CI 4.26-5.34 months). Patients with a ablation margin size of 11-15 mm experienced better PFS than those with a margin size of 6-10 or 0-5 mm (median, 6.5 versus [vs] 4.0 vs 2.3 months; < .001). PALBI grade demonstrated significantly greater area under the curve values than ALBI grade or CTP class in predicting 1-, 3- and 5-year OS. PALBI grade provided better predictive value than ALBI grade or CTP class in patients with large HCCs after TACE-MWA.
比较白蛋白-胆红素（ALBI）分级、血小板-ALBI（PALBI）分级和 Child-Turcotte-Pugh（CTP）分级在经动脉化疗栓塞（TACE）联合微波消融（TACE-MWA）治疗大肝癌（HCC）患者中的预测价值。本研究纳入了 2000 年 1 月至 2018 年 6 月期间在三个医疗中心接受 TACE-MWA 治疗的 349 例连续 HCC 患者（89.1%为男性；平均[±SD]年龄 53.4±12.27 岁），这些患者共接受了 3 次最大直径为 5.1-8.0cm 的 HCC 治疗。分析总生存期（OS）和无进展生存期（PFS）。比较了 ALBI 分级、PALBI 分级和 CTP 分级的预后性能。TACE 采用洛铂（20-50mg）、表阿霉素（30-60mg）、碘油（5-25mL）和明胶海绵颗粒（350-560μm）进行。TACE 治疗的终点为供血动脉血流停滞。中位随访时间为 28.0 个月，中位 OS 为 28.0 个月（95%可信区间[CI]为 23.55-32.45 个月），中位 PFS 为 4.8 个月（95%CI 为 4.26-5.34 个月）。消融边缘大小为 11-15mm 的患者的 PFS明显优于边缘大小为 6-10mm 或 0-5mm 的患者（中位 PFS：6.5 个月比 4.0 个月比 2.3 个月； < .001）。PALBI 分级在预测 1 年、3 年和 5 年 OS 方面的曲线下面积值明显大于 ALBI 分级或 CTP 分级。PALBI 分级在 TACE-MWA 治疗大 HCC 患者中的预测价值优于 ALBI 分级或 CTP 分级。
