Predictors of Successful Yttrium-90 Radioembolization Bridging or Downstaging in Patients with Hepatocellular Carcinoma
Purpose. This study aims to identify clinical and imaging prognosticators associated with the successful bridging or downstaging to liver transplantation (LT) in patients undergoing Yttrium-90 radioembolization (Y90-RE) for hepatocellular carcinoma (HCC). Methods. Retrospectively, patients with Y90-...
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| Veröffentlicht in: | Canadian Journal of Gastroenterology and Hepatology 2021, Vol.2021, p.9926704-14 |
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| creator | Villalobos, Alexander Wagstaff, William Guo, Mian Zhang, James Bercu, Zachary Whitmore, Morgan J. Cristescu, Mircea M Majdalany, Bill S. Wedd, Joel Akce, Mehmet Magliocca, Joseph Sellers, Marty T. Kokabi, Nima |
| description | Purpose. This study aims to identify clinical and imaging prognosticators associated with the successful bridging or downstaging to liver transplantation (LT) in patients undergoing Yttrium-90 radioembolization (Y90-RE) for hepatocellular carcinoma (HCC). Methods. Retrospectively, patients with Y90-RE naïve HCC who were candidates or potential candidates for LT and underwent Y90-RE were included. Patients were then divided into favorable (maintained or achieved Milan criteria (MC) eligibility) or unfavorable (lost eligibility or unchanged MC ineligibility) cohorts based on changes to their MC eligibility after Y90-RE. Penalized logistic regression analysis was performed to identify the significant baseline prognosticators. Results. Between 2013 and 2018, 135 patients underwent Y90-RE treatment. Among the 59 (42%) patients within MC, LT eligibility was maintained in 49 (83%) and lost in 10 (17%) patients. Within the 76 (56%) patients outside MC, eligibility was achieved in 32 (42%) and unchanged in 44 (58%). Among the 81 (60%) patients with a favorable response, 16 (20%) went on to receive LT. Analysis of the baseline characteristics revealed that lower Albumin-Bilirubin score, lower Child–Pugh class, lower Barcelona Clinic Liver Cancer stage, HCC diagnosis using dynamic contrast-enhanced imaging on CT or MRI, normal/higher albumin levels, decreased severity of tumor burden, left lobe HCC disease, and absence of HBV-associated cirrhosis, baseline abdominal pain, or fatigue were all associated with a higher likelihood of bridging or downstaging to LT eligibility (p’s |
| doi_str_mv | 10.1155/2021/9926704 |
| format | Article |
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This study aims to identify clinical and imaging prognosticators associated with the successful bridging or downstaging to liver transplantation (LT) in patients undergoing Yttrium-90 radioembolization (Y90-RE) for hepatocellular carcinoma (HCC). Methods. Retrospectively, patients with Y90-RE naïve HCC who were candidates or potential candidates for LT and underwent Y90-RE were included. Patients were then divided into favorable (maintained or achieved Milan criteria (MC) eligibility) or unfavorable (lost eligibility or unchanged MC ineligibility) cohorts based on changes to their MC eligibility after Y90-RE. Penalized logistic regression analysis was performed to identify the significant baseline prognosticators. Results. Between 2013 and 2018, 135 patients underwent Y90-RE treatment. Among the 59 (42%) patients within MC, LT eligibility was maintained in 49 (83%) and lost in 10 (17%) patients. Within the 76 (56%) patients outside MC, eligibility was achieved in 32 (42%) and unchanged in 44 (58%). Among the 81 (60%) patients with a favorable response, 16 (20%) went on to receive LT. Analysis of the baseline characteristics revealed that lower Albumin-Bilirubin score, lower Child–Pugh class, lower Barcelona Clinic Liver Cancer stage, HCC diagnosis using dynamic contrast-enhanced imaging on CT or MRI, normal/higher albumin levels, decreased severity of tumor burden, left lobe HCC disease, and absence of HBV-associated cirrhosis, baseline abdominal pain, or fatigue were all associated with a higher likelihood of bridging or downstaging to LT eligibility (p’s < 0.05). Conclusion. Certain baseline clinical and tumor characteristics are associated with the successful bridging or downstaging of potential LT candidates with HCC undergoing Y90-RE.</description><identifier>ISSN: 2291-2789</identifier><identifier>EISSN: 2291-2797</identifier><identifier>DOI: 10.1155/2021/9926704</identifier><identifier>PMID: 34336728</identifier><language>eng</language><publisher>Egypt: Hindawi</publisher><subject>Cancer therapies ; Candidates ; Carcinoma, Hepatocellular - radiotherapy ; Cholangiocarcinoma ; Humans ; Laboratories ; Liver cancer ; Liver cirrhosis ; Liver diseases ; Liver Neoplasms - radiotherapy ; Patients ; Retrospective Studies ; Transplants & implants ; Treatment Outcome ; Tumors ; Yttrium Radioisotopes - therapeutic use</subject><ispartof>Canadian Journal of Gastroenterology and Hepatology, 2021, Vol.2021, p.9926704-14</ispartof><rights>Copyright © 2021 Alexander Villalobos et al.</rights><rights>Copyright © 2021 Alexander Villalobos et al. This is an open access article distributed under the Creative Commons Attribution License (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. https://creativecommons.org/licenses/by/4.0</rights><rights>Copyright © 2021 Alexander Villalobos et al. 2021</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c514t-fe264171cab9f1713f7d95fbac92d6dfaf9bc9819c3f6f64fbcc30ef920128a13</citedby><cites>FETCH-LOGICAL-c514t-fe264171cab9f1713f7d95fbac92d6dfaf9bc9819c3f6f64fbcc30ef920128a13</cites><orcidid>0000-0002-8920-7459</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8324378/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8324378/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,873,881,4010,27900,27901,27902,53766,53768</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34336728$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Granito, Alessandro</contributor><creatorcontrib>Villalobos, Alexander</creatorcontrib><creatorcontrib>Wagstaff, William</creatorcontrib><creatorcontrib>Guo, Mian</creatorcontrib><creatorcontrib>Zhang, James</creatorcontrib><creatorcontrib>Bercu, Zachary</creatorcontrib><creatorcontrib>Whitmore, Morgan J.</creatorcontrib><creatorcontrib>Cristescu, Mircea M</creatorcontrib><creatorcontrib>Majdalany, Bill S.</creatorcontrib><creatorcontrib>Wedd, Joel</creatorcontrib><creatorcontrib>Akce, Mehmet</creatorcontrib><creatorcontrib>Magliocca, Joseph</creatorcontrib><creatorcontrib>Sellers, Marty T.</creatorcontrib><creatorcontrib>Kokabi, Nima</creatorcontrib><title>Predictors of Successful Yttrium-90 Radioembolization Bridging or Downstaging in Patients with Hepatocellular Carcinoma</title><title>Canadian Journal of Gastroenterology and Hepatology</title><addtitle>Can J Gastroenterol Hepatol</addtitle><description>Purpose. This study aims to identify clinical and imaging prognosticators associated with the successful bridging or downstaging to liver transplantation (LT) in patients undergoing Yttrium-90 radioembolization (Y90-RE) for hepatocellular carcinoma (HCC). Methods. Retrospectively, patients with Y90-RE naïve HCC who were candidates or potential candidates for LT and underwent Y90-RE were included. Patients were then divided into favorable (maintained or achieved Milan criteria (MC) eligibility) or unfavorable (lost eligibility or unchanged MC ineligibility) cohorts based on changes to their MC eligibility after Y90-RE. Penalized logistic regression analysis was performed to identify the significant baseline prognosticators. Results. Between 2013 and 2018, 135 patients underwent Y90-RE treatment. Among the 59 (42%) patients within MC, LT eligibility was maintained in 49 (83%) and lost in 10 (17%) patients. Within the 76 (56%) patients outside MC, eligibility was achieved in 32 (42%) and unchanged in 44 (58%). Among the 81 (60%) patients with a favorable response, 16 (20%) went on to receive LT. Analysis of the baseline characteristics revealed that lower Albumin-Bilirubin score, lower Child–Pugh class, lower Barcelona Clinic Liver Cancer stage, HCC diagnosis using dynamic contrast-enhanced imaging on CT or MRI, normal/higher albumin levels, decreased severity of tumor burden, left lobe HCC disease, and absence of HBV-associated cirrhosis, baseline abdominal pain, or fatigue were all associated with a higher likelihood of bridging or downstaging to LT eligibility (p’s < 0.05). Conclusion. Certain baseline clinical and tumor characteristics are associated with the successful bridging or downstaging of potential LT candidates with HCC undergoing Y90-RE.</description><subject>Cancer therapies</subject><subject>Candidates</subject><subject>Carcinoma, Hepatocellular - radiotherapy</subject><subject>Cholangiocarcinoma</subject><subject>Humans</subject><subject>Laboratories</subject><subject>Liver cancer</subject><subject>Liver cirrhosis</subject><subject>Liver diseases</subject><subject>Liver Neoplasms - radiotherapy</subject><subject>Patients</subject><subject>Retrospective Studies</subject><subject>Transplants & implants</subject><subject>Treatment Outcome</subject><subject>Tumors</subject><subject>Yttrium Radioisotopes - therapeutic use</subject><issn>2291-2789</issn><issn>2291-2797</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>RHX</sourceid><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><sourceid>DOA</sourceid><recordid>eNp9kctv1DAQhyNERavSG2dkiSOk9SNx7AsSLNBWqkTF48DJmvix61USL7bDCv563O6yai-cZmx_-sajX1W9IPickLa9oJiSCykp73DzpDqhVJKadrJ7euiFPK7OUlpjjAltW8nos-qYNYzxjoqTansbrfE6h5hQcOjrrLVNyc0D-pFz9PNYS4y-gPHBjn0Y_B_IPkzoffRm6aclChF9CNspZbg_-gndFsJOOaGtzyt0ZTeQg7bDMA8Q0QKi9lMY4Xl15GBI9mxfT6vvnz5-W1zVN58vrxfvbmrdkibXzlLekI5o6KUrlbnOyNb1oCU13DhwstdSEKmZ4443rteaYeskLdsKIOy0ut55TYC12kQ_QvytAnh1fxHiUkHMXg9W9bLl3GohdE-aRljouWalN8RgZwwrrrc712buR2t02TLC8Ej6-GXyK7UMv5RgtGGdKIJXe0EMP2ebslqHOU5lf1Wi6UhDCKeFerOjdAwpResOEwhWd6mru9TVPvWCv3z4qwP8L-MCvN4BKz8Z2Pr_6_4C-yC3-Q</recordid><startdate>2021</startdate><enddate>2021</enddate><creator>Villalobos, Alexander</creator><creator>Wagstaff, William</creator><creator>Guo, Mian</creator><creator>Zhang, James</creator><creator>Bercu, Zachary</creator><creator>Whitmore, Morgan J.</creator><creator>Cristescu, Mircea M</creator><creator>Majdalany, Bill S.</creator><creator>Wedd, Joel</creator><creator>Akce, Mehmet</creator><creator>Magliocca, Joseph</creator><creator>Sellers, Marty T.</creator><creator>Kokabi, Nima</creator><general>Hindawi</general><general>Hindawi Limited</general><scope>RHU</scope><scope>RHW</scope><scope>RHX</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8FQ</scope><scope>8FV</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>5PM</scope><scope>DOA</scope><orcidid>https://orcid.org/0000-0002-8920-7459</orcidid></search><sort><creationdate>2021</creationdate><title>Predictors of Successful Yttrium-90 Radioembolization Bridging or Downstaging in Patients with Hepatocellular Carcinoma</title><author>Villalobos, Alexander ; Wagstaff, William ; Guo, Mian ; Zhang, James ; Bercu, Zachary ; Whitmore, Morgan J. ; Cristescu, Mircea M ; Majdalany, Bill S. ; Wedd, Joel ; Akce, Mehmet ; Magliocca, Joseph ; Sellers, Marty T. ; Kokabi, Nima</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c514t-fe264171cab9f1713f7d95fbac92d6dfaf9bc9819c3f6f64fbcc30ef920128a13</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Cancer therapies</topic><topic>Candidates</topic><topic>Carcinoma, Hepatocellular - radiotherapy</topic><topic>Cholangiocarcinoma</topic><topic>Humans</topic><topic>Laboratories</topic><topic>Liver cancer</topic><topic>Liver cirrhosis</topic><topic>Liver diseases</topic><topic>Liver Neoplasms - radiotherapy</topic><topic>Patients</topic><topic>Retrospective Studies</topic><topic>Transplants & implants</topic><topic>Treatment Outcome</topic><topic>Tumors</topic><topic>Yttrium Radioisotopes - therapeutic use</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Villalobos, Alexander</creatorcontrib><creatorcontrib>Wagstaff, William</creatorcontrib><creatorcontrib>Guo, Mian</creatorcontrib><creatorcontrib>Zhang, James</creatorcontrib><creatorcontrib>Bercu, Zachary</creatorcontrib><creatorcontrib>Whitmore, Morgan J.</creatorcontrib><creatorcontrib>Cristescu, Mircea M</creatorcontrib><creatorcontrib>Majdalany, Bill S.</creatorcontrib><creatorcontrib>Wedd, Joel</creatorcontrib><creatorcontrib>Akce, Mehmet</creatorcontrib><creatorcontrib>Magliocca, Joseph</creatorcontrib><creatorcontrib>Sellers, Marty T.</creatorcontrib><creatorcontrib>Kokabi, Nima</creatorcontrib><collection>Hindawi Publishing Complete</collection><collection>Hindawi Publishing Subscription Journals</collection><collection>Hindawi Publishing Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Canadian Business & Current Affairs Database</collection><collection>Canadian Business & Current Affairs Database (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>Canadian Journal of Gastroenterology and Hepatology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Villalobos, Alexander</au><au>Wagstaff, William</au><au>Guo, Mian</au><au>Zhang, James</au><au>Bercu, Zachary</au><au>Whitmore, Morgan J.</au><au>Cristescu, Mircea M</au><au>Majdalany, Bill S.</au><au>Wedd, Joel</au><au>Akce, Mehmet</au><au>Magliocca, Joseph</au><au>Sellers, Marty T.</au><au>Kokabi, Nima</au><au>Granito, Alessandro</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Predictors of Successful Yttrium-90 Radioembolization Bridging or Downstaging in Patients with Hepatocellular Carcinoma</atitle><jtitle>Canadian Journal of Gastroenterology and Hepatology</jtitle><addtitle>Can J Gastroenterol Hepatol</addtitle><date>2021</date><risdate>2021</risdate><volume>2021</volume><spage>9926704</spage><epage>14</epage><pages>9926704-14</pages><issn>2291-2789</issn><eissn>2291-2797</eissn><abstract>Purpose. This study aims to identify clinical and imaging prognosticators associated with the successful bridging or downstaging to liver transplantation (LT) in patients undergoing Yttrium-90 radioembolization (Y90-RE) for hepatocellular carcinoma (HCC). Methods. Retrospectively, patients with Y90-RE naïve HCC who were candidates or potential candidates for LT and underwent Y90-RE were included. Patients were then divided into favorable (maintained or achieved Milan criteria (MC) eligibility) or unfavorable (lost eligibility or unchanged MC ineligibility) cohorts based on changes to their MC eligibility after Y90-RE. Penalized logistic regression analysis was performed to identify the significant baseline prognosticators. Results. Between 2013 and 2018, 135 patients underwent Y90-RE treatment. Among the 59 (42%) patients within MC, LT eligibility was maintained in 49 (83%) and lost in 10 (17%) patients. Within the 76 (56%) patients outside MC, eligibility was achieved in 32 (42%) and unchanged in 44 (58%). Among the 81 (60%) patients with a favorable response, 16 (20%) went on to receive LT. Analysis of the baseline characteristics revealed that lower Albumin-Bilirubin score, lower Child–Pugh class, lower Barcelona Clinic Liver Cancer stage, HCC diagnosis using dynamic contrast-enhanced imaging on CT or MRI, normal/higher albumin levels, decreased severity of tumor burden, left lobe HCC disease, and absence of HBV-associated cirrhosis, baseline abdominal pain, or fatigue were all associated with a higher likelihood of bridging or downstaging to LT eligibility (p’s < 0.05). Conclusion. Certain baseline clinical and tumor characteristics are associated with the successful bridging or downstaging of potential LT candidates with HCC undergoing Y90-RE.</abstract><cop>Egypt</cop><pub>Hindawi</pub><pmid>34336728</pmid><doi>10.1155/2021/9926704</doi><tpages>14</tpages><orcidid>https://orcid.org/0000-0002-8920-7459</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Cancer therapies Candidates Carcinoma, Hepatocellular - radiotherapy Cholangiocarcinoma Humans Laboratories Liver cancer Liver cirrhosis Liver diseases Liver Neoplasms - radiotherapy Patients Retrospective Studies Transplants & implants Treatment Outcome Tumors Yttrium Radioisotopes - therapeutic use |
| title | Predictors of Successful Yttrium-90 Radioembolization Bridging or Downstaging in Patients with Hepatocellular Carcinoma |
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