Awiwi Muhammad O, Elsayes Khaled M, Mohamed Yehia I, Altameemi Lina, Gjoni Migena, Irshad Omayr Muhammad, Sayed Ahmed Ahmed, Kaseb Ahmad O, Salem Usama
Department of Diagnostic Imaging, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Department of Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
J Hepatocell Carcinoma. 2022 Aug 30;9:913-927. doi: 10.2147/JHC.S379428. eCollection 2022.
To identify prognostic clinical and radiologic features in patients with unresectable hepatocellular carcinoma (HCC) treated with atezolizumab plus bevacizumab.
Clinical and imaging records of patients with unresectable HCC were retrospectively reviewed, and baseline features were recorded. Patients' records and imaging studies were used to determine the patients' overall survival (OS) and progression-free survival (PFS). Univariate and multivariate analyses were performed to determine prognostic features. Subanalyses of treatment-naïve patients (who never received local or systemic therapy) and previously treated patients were also performed.
Fifty-five patients were included in the final analysis, 23 (41.8%) of whom were treatment naïve. The median PFS and OS for the entire cohort were 3.0 months and 7.9 months. The 3-, 6- and 12-month OS rates were 85.5%, 79.8% and 45.7%, respectively. The 3-, 6- and 12-month PFS rates were 50.1%, 41.2% and 20.1%, respectively. On multivariate analysis, independent prognostic features for poor PFS of the entire cohort were pleural effusions (p = 0.047, HR: 6.3; CI: 1.03-38.90) and hepatic vein tumor thrombus (p = 0.005; HR: 23.37; CI: 2.63-207.67); independent prognostic features for poor OS were ascites (p = 0.008; HR: 37.37; CI: 2.53-467.64), pleural effusion (p = 0.003; HR: 110.17; CI: 5.00-2426.54), and low (<40HU) pre-contrast attenuation on CT images (p = 0.007; HR: 0.09; CI: 0.02-0.53). On subanalysis of treatment-naïve patients, the median OS and PFS were 7.4 months and 2.8 months, respectively. The 3-, 6- and 12-month PFS rates were 43.5%, 38.6% and 24.8%, respectively. Pleural effusion was the only independent poor prognostic feature (p = 0.036; HR: 206.34; CI: 1.41-30,167.58).
Independent prognostic features for survival outcomes include the presence of ascites, pleural effusions, hepatic vein tumor thrombus, and HCC with low attenuation (<40 HU) on unenhanced CT images. Although several biochemical variables were significant on univariate analysis, none were independent predictors of OS or PFS.
确定接受阿替利珠单抗联合贝伐单抗治疗的不可切除肝细胞癌（HCC）患者的预后临床和放射学特征。
回顾性分析不可切除HCC患者的临床和影像记录，并记录基线特征。利用患者记录和影像研究确定患者的总生存期（OS）和无进展生存期（PFS）。进行单因素和多因素分析以确定预后特征。还对未接受过治疗的患者（从未接受过局部或全身治疗）和既往接受过治疗的患者进行了亚组分析。
最终纳入55例患者进行分析，其中23例（41.8%）为未接受过治疗的患者。整个队列的中位PFS和OS分别为3.0个月和7.9个月。3个月、6个月和12个月的OS率分别为85.5%、79.8%和45.7%。3个月、6个月和12个月的PFS率分别为50.1%、41.2%和20.1%。多因素分析显示，整个队列中PFS不良的独立预后特征为胸腔积液（p = 0.047，HR：6.3；CI：1.03 - 38.90）和肝静脉肿瘤血栓（p = 0.005；HR：23.37；CI：2.63 - 207.67）；OS不良的独立预后特征为腹水（p = 0.008；HR：37.37；CI：2.53 - 467.64）、胸腔积液（p = 0.003；HR：110.17；CI：5.00 - 2426.54）以及CT图像上平扫前低密度（<40HU）（p = 0.007；HR：0.09；CI：0.02 - 0.53）。在未接受过治疗的患者亚组分析中，中位OS和PFS分别为7.4个月和2.8个月。3个月、6个月和12个月的PFS率分别为43.5%、38.6%和24.8%。胸腔积液是唯一独立的不良预后特征（p = 0.036；HR：206.34；CI：1.41 - 30167.58）。
生存结果的独立预后特征包括腹水、胸腔积液、肝静脉肿瘤血栓的存在以及CT平扫图像上低密度（<40HU）的HCC。虽然几个生化变量在单因素分析中有意义，但均不是OS或PFS的独立预测因素。
