Zhao Ken, Karimi Anita, Kelly Luke, Petre Elena, Marinelli Brett, Alexander Erica S, Sotirchos Vlasios S, Erinjeri Joseph P, Covey Anne, Sofocleous Constantinos T, Harding James J, Jarnagin William, Sigel Carlie, Vakiani Efsevia, Ziv Etay, Yarmohammadi Hooman
Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA.
Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA.
Curr Oncol. 2025 Jan 18;32(1):51. doi: 10.3390/curroncol32010051.
The aim of this study was to evaluate associations between TP53 status and outcomes after transarterial embolization (TAE) for the treatment of patients with hepatocellular carcinoma (HCC). This single-institution study included patients from 1/2014 to 6/2022 who underwent TAE of HCC and genomic analysis of tumoral tissue. The primary outcome was overall survival (OS) with relation to TP53 status, and the secondary outcome was the time to progression. Survival analysis was performed using the Kaplan-Meier method. The time to progression with death or the last patient contact without progression as competing risks were used to obtain a cumulative incidence function, and the association with TP53 status was evaluated using the Gray test. In total, 75 patients (63 men) with a median age of 70.0 (IQR 62.0-76.3) years were included. Of these, 26/75 (34.7%) patients had TP53-mutant HCC. Patients with TP53-mutant HCC had a significantly worse median OS of 15.2 (95% CI, 9.5-29.3) months, versus 31.2 (95% CI, 21.2-52.4) months as the median OS ( = 0.023) for TP53 wild-type HCC. Competing risk analysis showed a shorter time to local hepatic progression (at the site of the previously treated tumor) after TAE in patients with TP53-mutant HCC. The cumulative incidences of local progression at 6 and 12 months for TP53-mutant HCC were 65.4% and 84.6%, versus 40.8% and 55.1% for TP53 wild-type HCC ( = 0.0072). A TP53 mutation may predict a worse overall survival and a shorter time to local progression in HCC patients treated with TAE.
本研究旨在评估经动脉栓塞术（TAE）治疗肝细胞癌（HCC）患者后，TP53状态与治疗结果之间的关联。这项单机构研究纳入了2014年1月至2022年6月期间接受HCC TAE及肿瘤组织基因分析的患者。主要结局是与TP53状态相关的总生存期（OS），次要结局是疾病进展时间。采用Kaplan-Meier法进行生存分析。将死亡或最后一次无进展患者接触时的疾病进展时间作为竞争风险，以获得累积发病率函数，并使用Gray检验评估与TP53状态的关联。总共纳入了75例患者（63例男性），中位年龄为70.0（四分位间距62.0 - 76.3）岁。其中，26/75（34.7%）例患者为TP53突变型HCC。TP53突变型HCC患者的中位OS显著更差，为15.2（95%置信区间，9.5 - 29.3）个月，而TP53野生型HCC的中位OS为31.2（95%置信区间，21.2 - 52.4）个月（P = 0.023）。竞争风险分析显示，TP53突变型HCC患者TAE后局部肝进展（在先前治疗肿瘤部位）的时间更短。TP53突变型HCC在6个月和12个月时的局部进展累积发生率分别为65.4%和84.6%，而TP53野生型HCC分别为40.8%和55.1%（P = 0.0072）。TP53突变可能预示TAE治疗的HCC患者总生存期更差且局部进展时间更短。
