Lei Kai, Wang Jia-Guo, Li Yin, Wang Hong-Xiang, Xu Jie, You Ke, Liu Zuo-Jin
Department of Hepatobiliary Surgery, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, 400000, China.
Heliyon. 2023 Jul 20;9(8):e18494. doi: 10.1016/j.heliyon.2023.e18494. eCollection 2023 Aug.
This retrospective study analyzed the prognostic value of preoperative prealbumin (PAB) levels in patients with unresectable hepatocellular carcinoma (HCC) after transcatheter arterial chemoembolisation (TACE).
Four hundred and two patients diagnosed with unresectable HCC were included in this retrospective study. All patients underwent their first TACE procedure. Based on PAB levels before the first TACE, 402 patients were classified as having low PAB levels and high PAB levels. Potential confounding factors between the two groups were eliminated using. Propensity Score Matching (PSM) analysis. The time to progression (TTP) and overall survival (OS) of the two groups were compared using Kaplan-Meier curves before and after PSM. Risk factors for poor prognosis were determined using univariate and multivariate Cox proportional hazards models.
Before PSM, the high PAB level group had a significantly longer median TTP and OS than the low PAB level group (all P values < 0.0001). After PSM, the high PAB level group still had a significantly longer median TTP and OS than the low PAB level group (all P values < 0.05). After PSM, low PAB level was found to be an independent predictor of shorter OS (HR = 0.656; 95% CI:0.448-0.961; P = 0.03). The subgroup analysis before PSM showed that low PAB levels increased the risk of poor prognosis in most subgroups.
Low preoperative PAB levels are associated with poor prognosis in patients with unresectable HCC after TACE.
本回顾性研究分析了术前前白蛋白（PAB）水平对不可切除肝细胞癌（HCC）患者经动脉化疗栓塞术（TACE）后预后的价值。
本回顾性研究纳入了402例诊断为不可切除HCC的患者。所有患者均接受了首次TACE治疗。根据首次TACE治疗前的PAB水平，将402例患者分为低PAB水平组和高PAB水平组。采用倾向评分匹配（PSM）分析消除两组之间潜在的混杂因素。使用Kaplan-Meier曲线比较PSM前后两组的进展时间（TTP）和总生存期（OS）。采用单因素和多因素Cox比例风险模型确定预后不良的危险因素。
在PSM之前，高PAB水平组的中位TTP和OS明显长于低PAB水平组（所有P值<0.0001）。PSM之后，高PAB水平组的中位TTP和OS仍然明显长于低PAB水平组（所有P值<0.05）。PSM之后，发现低PAB水平是OS较短的独立预测因素（HR=0.656；95%CI：0.448-0.961；P=0.03）。PSM之前的亚组分析表明，低PAB水平在大多数亚组中增加了预后不良的风险。
术前低PAB水平与TACE术后不可切除HCC患者的预后不良相关。
