Rak wątroby – Rokowania, prognozy i postęp choroby

Rak wątroby
Rokowania, prognozy i postęp choroby

Rokowanie w raku wątroby (HCC) zależy od wielu czynników klinicznych i patologicznych, w tym stadium zaawansowania według klasyfikacji BCLC, funkcji wątroby ocenianej skalą Child-Pugh, stanu sprawności wg ECOG, liczby i lokalizacji guzów oraz obecności inwazji naczyniowej. Pacjenci z wczesnym stadium BCLC 0/A mają 5-letnie przeżycie na poziomie 50-70% po leczeniu chirurgicznym, przeszczepie lub ablacji, podczas gdy w stadium BCLC B, C i D mediana przeżycia wynosi odpowiednio 16 miesięcy (do 40 miesięcy z TACE), 11-13 miesięcy i 3-4 miesiące. Modele prognostyczne, takie jak skala HAP (indeks C=0,742), Six-and-Twelve, Up to Seven oraz ALBI, wykorzystują parametry biochemiczne (AFP, albumina, bilirubina), cechy guza i obecność przerzutów, aby przewidywać całkowite przeżycie (OS) i przeżycie wolne od progresji (PFS). Niezależnymi czynnikami prognostycznymi są m.in. wynik ALBI (HR=0,624, p=0,012), obecność zakrzepu nowotworowego żyły wrotnej (PVTT, HR=0,522, p<0,001) oraz rozmiar guza (HR=0,512, p<0,001).

Prognoza raka wątroby (Rak wątroby)

Wskaźniki prognostyczne w raku wątroby
Modele prognostyczne w raku wątroby
Statystyki przeżycia w raku wątroby
Nowe biomarkery prognostyczne
Postępy w leczeniu i ich wpływ na prognozę
Kolejne rozdziały

Prognoza raka wątroby (Rak wątroby)

Prognoza w raku wątroby to najlepsza ocena lekarza dotycząca tego, jak nowotwór wpłynie na pacjenta i jak zareaguje na leczenie. Rokowanie i przeżycie zależą od wielu czynników, a jedynie lekarz znający historię medyczną pacjenta, typ, stadium i inne cechy nowotworu, wybrane metody leczenia oraz odpowiedź na leczenie może połączyć wszystkie te informacje ze statystykami przeżycia, aby określić prognozę¹.

Wskaźniki prognostyczne w raku wątroby

Istnieje szereg czynników, które mają wpływ na rokowanie pacjentów z rakiem wątroby:

Stadium zaawansowania choroby

Stadium zaawansowania jest jednym z najważniejszych czynników prognostycznych w raku wątroby. Pacjenci z rakiem wątroby w stadium BCLC 0 lub A mają korzystniejsze rokowanie niż pacjenci z rakiem wątroby w stadium BCLC B, C lub D¹. System klasyfikacji BCLC (Barcelona Clinic Liver Cancer) jest szeroko stosowany w wytycznych dotyczących postępowania w raku wątrobowo-komórkowym².

Funkcja wątroby

Osoby z upośledzoną funkcją wątroby spowodowaną guzem, bliznowaceniem wątroby (marskość) lub zapaleniem wątroby mają złe rokowanie¹. Wysoki wynik w skali Child-Pugh oznacza, że operacja nie jest bezpieczna i nie powinna być wykonywana. Pacjenci, którzy nie mogą być poddani operacji, mają gorsze rokowanie niż osoby, u których można przeprowadzić zabieg chirurgiczny w celu usunięcia raka wątroby².

Stan sprawności

Stan sprawności mierzy, jak dobrze pacjent może wykonywać codzienne czynności i opiera się na skali Eastern Cooperative Oncology Group (ECOG). Osoby z dobrym lub zadowalającym stanem sprawności mają lepsze rokowanie niż osoby ze słabym stanem sprawności³.

Charakterystyka guza

Osoby z tylko jednym guzem w wątrobie mają lepsze rokowanie niż osoby z wieloma guzami. Gdy guzy znajdują się w jednym płacie, rokowanie jest lepsze niż gdy guzy znajdują się w obu płatach wątroby⁴. Guz rosnący wewnątrz naczyń krwionośnych lub który wrósł w naczynia krwionośne ma złe rokowanie⁵.

Typ histologiczny

Rak włóknisto-blaszkowy (fibrolamellar carcinoma) ma lepsze rokowanie niż inne typy raka wątroby. Te guzy nie rosną zbyt głęboko w otaczających tkankach, więc lekarze zwykle mogą całkowicie usunąć je operacyjnie⁶.

Modele prognostyczne w raku wątroby

Opracowano i zwalidowano wiele modeli prognostycznych dla pacjentów z rakiem wątrobowo-komórkowym (HCC) poddawanych leczeniu systemowemu. Badania systematyczne zidentyfikowały 42 kwalifikujące się artykuły: 28 opisujących opracowanie 28 modeli prognostycznych, a 14 opisujących zewnętrzną walidację 32 istniejących modeli prognostycznych⁷⁸.

Najczęstszymi wskaźnikami klinicznymi do przewidywania rokowania pacjentów z HCC po leczeniu systemowym były całkowite przeżycie (OS) i przeżycie wolne od progresji (PFS)⁹. Najczęściej stosowanymi predyktorami były: alfa-fetoproteina (AFP), albumina, bilirubina, klasa Child-Pugh, przerzuty pozawątrobowe, rozmiar guza i inwazja naczyń¹⁰¹¹.

Systemy oceny prognostycznej

Szereg systemów oceny prognostycznej wykazał wartość w przewidywaniu wyników u pacjentów z rakiem wątrobowo-komórkowym:

Skala HAP (Hepatoma Arterial-embolisation Prognostic)
Skala Six-and-Twelve
Skala Up to Seven
Skala ALBI (Albumin-Bilirubin)¹²¹³

W badaniach porównujących te systemy oceny, model HAP wykazał najwyższy indeks C wynoszący 0,742, wskazując na najlepszą zdolność przewidywania przeżycia, następnie skala Six-and-Twelve (0,701), skala Up to Seven (0,698) i skala ALBI (0,601)¹⁴¹⁵.

Analiza modelu proporcjonalnego hazardu Coxa wykazała, że wynik ALBI, obecność zakrzepu nowotworowego żyły wrotnej (PVTT) i rozmiar guza są niezależnymi determinantami przeżycia prognostycznego¹⁶. Badanie wykazało, że wynik ALBI (HR=0,624, 95% CI 0,427-0,842, p=0,012) miał niezależny wpływ na całkowite przeżycie. Ponadto obecność PVTT (HR=0,522, 95% CI 0,453-0,732, p<0,001) i rozmiar guza (HR=0,512, 95% CI 0,361-0,723, p<0,001) również zostały zidentyfikowane jako niezależne czynniki ryzyka dla całkowitego przeżycia¹⁷.

Rola zubożenia mięśniowego w prognozowaniu

Zubożenie mięśniowe (MD – Muscle Depletion) jest kluczowym predyktorem przeżycia w raku wątrobowo-komórkowym, ale często jest wykluczane z obecnych narzędzi prognostycznych. Badania wykazały, że niezależnymi predyktorami OS u pacjentów z HCC są infekcja wirusem zapalenia wątroby typu B, infekcja wirusem zapalenia wątroby typu C, marskość wątroby, rozmiar guza, poziomy alfa-fetoproteiny w surowicy oraz wskaźniki związane z MD (stosunek mięśnia lędźwiowego do kręgosłupa, stosunek mięśnia lędźwiowego do kręgu i miostatoza)¹⁸.

Włączenie MD znacznie poprawiło dokładność predykcyjną istniejących modeli, przy czym model MD-BCLC wykazał najwyższą wartość AUROC (0,804, 95% CI: 0,777-0,832, p < 0,001)¹⁹. Pacjenci z zubożeniem mięśniowym mieli krótsze przeżycie niż ci bez niego [1,46 lat, 95% CI: 1,12-1,77 vs 4,29 lat, 95% CI: 3,27-5,30, p < 0,001]²⁰.

Modele prognostyczne oparte na sztucznej inteligencji

Rozwiązania oparte na sztucznej inteligencji (AI) do przewidywania wyników leczenia i przeżycia pojawiły się w ostatnich latach, z potencjałem kształtowania przyszłych wytycznych dotyczących HCC²¹. Z powodzeniem opracowano algorytmy AI do przewidywania odpowiedzi na chemoembolizację przeztętniczą (TACE) i przeżycia po niej²².

Niedawno opracowano model skali oceny ryzyka (RSSM) do stratyfikacji ryzyka prognostycznego po terapiach wewnątrztętniczych (IAT) w HCC. Model CatBoost osiągnął najlepszą dyskryminację przy wprowadzeniu 12 najważniejszych zmiennych, z AUC 0,851 (95% CI, 0,833-0,868) dla TD, 0,817 (95% CI, 0,759-0,857) dla ITD i 0,791 (95% CI, 0,748-0,834) dla ETD²³.

Statystyki przeżycia w raku wątroby

Statystyki przeżycia dla raka wątroby są bardzo ogólnymi szacunkami i muszą być interpretowane bardzo ostrożnie. Ponieważ statystyki te opierają się na doświadczeniu grup ludzi, nie mogą być stosowane do przewidywania szans przeżycia konkretnej osoby²⁴.

Wskaźniki przeżycia

W Kanadzie 5-letnie przeżycie netto dla raka wątroby wynosi 22%. Oznacza to, że średnio około 22% osób z rozpoznanym rakiem wątroby przeżyje co najmniej 5 lat²⁵. W USA, relatywny wskaźnik przeżycia 5-letniego dla wczesnego stadium (stadium I lub II) raka wątroby wynosi 37%. Ten wskaźnik przeżycia spada do 13% dla raka wątroby w stadium III i 3% dla raka wątroby w stadium IV²⁶.

Przeżycie według stadium raka wątroby jest zwykle podawane jako mediana przeżycia. Mediana przeżycia to długość czasu (zwykle miesiące lub lata) po diagnozie lub rozpoczęciu leczenia, w którym połowa osób z tym typem raka nadal żyje²⁷:

Stadium BCLC	Mediana przeżycia	Przeżycie 5-letnie z leczeniem
BCLC 0/A (bardzo wczesne/wczesne)	–	50% do 70% (po resekcji wątroby, przeszczepie wątroby lub RFA)
BCLC B (pośrednie)	16 miesięcy (do 40 miesięcy z TACE)	–
BCLC C (zaawansowane)	11-13 miesięcy z leczeniem, 6-8 miesięcy bez leczenia	–
BCLC D (terminalne)	3-4 miesiące	–

²⁸²⁹

Czynniki wpływające na przeżycie

Ogólnie rzecz biorąc, wskaźniki przeżycia są wyższe dla osób, które mogą być poddane operacji usunięcia nowotworu, niezależnie od stadium. Na przykład, badania wykazały, że pacjenci z małymi, resekcyjnymi (możliwymi do usunięcia) guzami, którzy nie mają marskości wątroby ani innych poważnych problemów zdrowotnych, mają dobre rokowanie, jeśli ich nowotwory zostaną usunięte. W przypadku osób z rakiem wątroby we wczesnym stadium, które przeszły przeszczep wątroby, 5-letni wskaźnik przeżycia wynosi od 60% do 70%³⁰.

Udane przeszczepy wątroby mogą wyleczyć raka wątroby. Ale nie każdy, kto potrzebuje przeszczepu wątroby, może go otrzymać. Na przykład mogą nie być wystarczająco zdrowi, aby przejść przeszczep. Znalezienie odpowiedniej wątroby do przeszczepu może być również trudne³¹.

Znaczenie wczesnego wykrycia

Wczesna diagnoza jest związana z lepszym przeżyciem. Gdy rak wątroby jest diagnozowany w najwcześniejszym stadium, 78% ludzi może przeżyć rok lub dłużej, w porównaniu z 20%, gdy jest diagnozowany w najpóźniejszym stadium³². Modele przewidywania ryzyka do oszacowania przyszłego ryzyka rozwoju raka wątroby u poszczególnych pacjentów zwiększyłyby wczesne wykrywanie i diagnozowanie raka wątroby w populacji angielskiej i mogłyby wpłynąć na strategie badań przesiewowych i profilaktyki³³.

Nowe biomarkery prognostyczne

Trwają badania nad nowymi biomarkerami, które mogą pomóc przewidzieć wyniki leczenia i przeżycie u pacjentów z rakiem wątroby.

MicroRNA jako biomarkery

Krążące poziomy microRNA-193a-5p okazały się być predykcyjne dla pooperacyjnego wyniku pacjentów z HCC, co zostało potwierdzone w jedno- i wieloczynnikowej analizie regresji Coxa. Pacjenci z HCC z przedoperacyjnym poziomem miR-193a-5p powyżej idealnej wartości odcięcia (3,57) mieli medianę przeżycia całkowitego (OS) wynoszącą tylko 451 dni w porównaniu do 1158 dni u pacjentów z poziomem miR-193a-5p poniżej tej wartości³⁴. Co ważne, względne krążące poziomy miR-193a-5p okazały się niezależnym markerem prognostycznym dla OS³⁵.

Struktury limfoidalne trzeciego rzędu

Pacjenci z HCC i wysoką gęstością okołoguzkowych struktur limfoidalnych trzeciego rzędu (pTLS) doświadczyli wydłużonej mediany przeżycia całkowitego (p≤0,05) i korzystnej odpowiedzi na immunoterapię (p=0,03)³⁶. Grupa o wysokiej gęstości pTLS była znacząco skorelowana z poprawą całkowitego przeżycia (OS) i przeżycia wolnego od nawrotu (RFS) (oba log-rank p≤0,05) w kohortach TCGA-LIHC (n=363) i własnych (n=660)³⁷.

Signature związana z Cuprotpozą

Opracowano nowatorski profil lncRNA związany z Cuprotozą, który może być wykorzystany do przewidywania przeżycia i odpowiedzi na immunoterapię u pacjentów z HCC. Wysoka ekspresja pięciu zidentyfikowanych genów była ściśle związana ze złym rokowaniem u pacjentów z HCC³⁸³⁹.

Pacjenci z niższymi wynikami ryzyka mieli lepsze wyniki przeżycia zarówno w kohorcie treningowej, testowej, jak i kohorcie TCGA. Według analizy czasowej ROC, ta sygnatura ma dużą zdolność predykcyjną, z AUC wynoszącymi 0,739, 0,725 i 0,734 w kohorcie treningowej, 0,709, 0,708 i 0,698 w kohorcie testowej oraz 0,716, 0,708, 0,719 w kohorcie TCGA odpowiednio w jednym, trzech i pięciu latach⁴⁰.

Postępy w leczeniu i ich wpływ na prognozę

Badacze dokonują postępów w leczeniu raka wątroby, dzięki czemu ludzie mogą żyć dłużej. Jednak rak wątroby pozostaje chorobą zagrażającą życiu. Jak długo będziesz żyć z rakiem wątroby, zależy od takich czynników, jak stadium nowotworu, reakcja na leczenie i stan zdrowia⁴¹.

Osoby obecnie diagnozowane z rakiem wątroby mogą mieć lepsze rokowanie niż pokazują statystyki. Metody leczenia z czasem się poprawiają, a przedstawione dane są oparte na osobach, które zostały zdiagnozowane i leczone co najmniej pięć lat wcześniej⁴².

Obecne główne postępy wpłynęły na leczenie pacjentów z zaawansowanym HCC⁴³. Przeprowadzono szereg przełomowych badań, w tym pierwsze badanie wykazujące korzyść przeżycia dla terapii systemowych (sorafenib) w zaawansowanym HCC w porównaniu z placebo, oraz pierwsze badanie wykazujące korzyść przeżycia w leczeniu drugiej linii dla pacjentów z zaawansowanym HCC z progresją po terapii sorafenibem⁴⁴.

Wyniki trwających badań klinicznych mogą zmienić krajobraz zarządzania HCC na wszystkich etapach ewolucyjnych⁴⁵.

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Materiały źródłowe

#1 Prognosis and survival for liver cancer | Canadian Cancer Society
https://cancer.ca/en/cancer-information/cancer-types/liver/prognosis-and-survival
If you have liver cancer, you may have questions about your prognosis. A prognosis is the doctors best estimate of how cancer will affect someone and how it will respond to treatment. Prognosis and survival depend on many factors. Only a doctor familiar with your medical history, the type and stage and other features of the cancer, treatments chosen and the response to treatment can put all of this information together with survival statistics to arrive at a prognosis. […] The following are prognostic and predictive factors for liver cancer. […] The stage is one of the most important factors for liver cancer. People with liver cancer that is BCLC stage 0 or A have a more favourable prognosis than people with liver cancer that is BCLC stage B, C or D. […] People with poor liver function caused by the tumour, scarring of the liver (called cirrhosis) or hepatitis have a poor prognosis.
#2 Hepatocellular carcinoma | Nature Reviews Disease Primers
https://www.nature.com/articles/s41572-020-00240-3
The first description of the BCLC classification widely used in guidelines of management of HCC. […] This is a landmark study establishing the criteria for liver transplantation in HCC. […] This paper is the first study demonstrating survival benefit for any systemic therapies compared with the standard of care sorafenib in advanced HCC. […] This is the first study demonstrating a survival benefit similar to the standard of care sorafenib in advanced HCC compared with placebo. […] The first study demonstrating survival benefit in second-line treatment for patients with advanced HCC progressing to sorafenib therapy. […] This is a comprehensive genomic study conducted in HCC describing the landscape of mutations and mutational signatures. […] This paper is a meta-analysis of randomized studies providing the rationale to use transarterial chemoembolization in intermediate HCC as standard of care.
#2 Prognosis and survival for liver cancer | Canadian Cancer Society
https://cancer.ca/en/cancer-information/cancer-types/liver/prognosis-and-survival
A high Child-Pugh score means that surgery is not safe to do and should not be performed. People who cant have surgery have a poorer prognosis than people who can have surgery to remove liver cancer. […] Performance status measures how well you can do daily activities and is based on the Eastern Cooperative Oncology Group (ECOG) score. People with a good or fair performance status have a better prognosis than people with a poor performance status. […] People with only one tumour in the liver have a better prognosis than people with many tumours. When the tumours are all in one lobe, the prognosis is better than when the tumours are in both lobes of the liver. […] A tumour growing inside or that has grown into blood vessels has a poor prognosis. […] Fibrolamellar carcinoma has a better prognosis than other types of liver cancer. These tumours do not grow very deeply into the surrounding tissues, so doctors can usually completely remove them with surgery.
#3 Prognosis and survival for liver cancer | Canadian Cancer Society
https://cancer.ca/en/cancer-information/cancer-types/liver/prognosis-and-survival
A high Child-Pugh score means that surgery is not safe to do and should not be performed. People who cant have surgery have a poorer prognosis than people who can have surgery to remove liver cancer. […] Performance status measures how well you can do daily activities and is based on the Eastern Cooperative Oncology Group (ECOG) score. People with a good or fair performance status have a better prognosis than people with a poor performance status. […] People with only one tumour in the liver have a better prognosis than people with many tumours. When the tumours are all in one lobe, the prognosis is better than when the tumours are in both lobes of the liver. […] A tumour growing inside or that has grown into blood vessels has a poor prognosis. […] Fibrolamellar carcinoma has a better prognosis than other types of liver cancer. These tumours do not grow very deeply into the surrounding tissues, so doctors can usually completely remove them with surgery.
#4 Prognosis and survival for liver cancer | Canadian Cancer Society
https://cancer.ca/en/cancer-information/cancer-types/liver/prognosis-and-survival
A high Child-Pugh score means that surgery is not safe to do and should not be performed. People who cant have surgery have a poorer prognosis than people who can have surgery to remove liver cancer. […] Performance status measures how well you can do daily activities and is based on the Eastern Cooperative Oncology Group (ECOG) score. People with a good or fair performance status have a better prognosis than people with a poor performance status. […] People with only one tumour in the liver have a better prognosis than people with many tumours. When the tumours are all in one lobe, the prognosis is better than when the tumours are in both lobes of the liver. […] A tumour growing inside or that has grown into blood vessels has a poor prognosis. […] Fibrolamellar carcinoma has a better prognosis than other types of liver cancer. These tumours do not grow very deeply into the surrounding tissues, so doctors can usually completely remove them with surgery.
#5 Prognosis and survival for liver cancer | Canadian Cancer Society
https://cancer.ca/en/cancer-information/cancer-types/liver/prognosis-and-survival
A high Child-Pugh score means that surgery is not safe to do and should not be performed. People who cant have surgery have a poorer prognosis than people who can have surgery to remove liver cancer. […] Performance status measures how well you can do daily activities and is based on the Eastern Cooperative Oncology Group (ECOG) score. People with a good or fair performance status have a better prognosis than people with a poor performance status. […] People with only one tumour in the liver have a better prognosis than people with many tumours. When the tumours are all in one lobe, the prognosis is better than when the tumours are in both lobes of the liver. […] A tumour growing inside or that has grown into blood vessels has a poor prognosis. […] Fibrolamellar carcinoma has a better prognosis than other types of liver cancer. These tumours do not grow very deeply into the surrounding tissues, so doctors can usually completely remove them with surgery.
#6 Prognosis and survival for liver cancer | Canadian Cancer Society
https://cancer.ca/en/cancer-information/cancer-types/liver/prognosis-and-survival
A high Child-Pugh score means that surgery is not safe to do and should not be performed. People who cant have surgery have a poorer prognosis than people who can have surgery to remove liver cancer. […] Performance status measures how well you can do daily activities and is based on the Eastern Cooperative Oncology Group (ECOG) score. People with a good or fair performance status have a better prognosis than people with a poor performance status. […] People with only one tumour in the liver have a better prognosis than people with many tumours. When the tumours are all in one lobe, the prognosis is better than when the tumours are in both lobes of the liver. […] A tumour growing inside or that has grown into blood vessels has a poor prognosis. […] Fibrolamellar carcinoma has a better prognosis than other types of liver cancer. These tumours do not grow very deeply into the surrounding tissues, so doctors can usually completely remove them with surgery.
#7 Prognostic models for outcome prediction in patients with advanced hepatocellular carcinoma treated by systemic therapy: a systematic review and critical appraisal
https://pmc.ncbi.nlm.nih.gov/articles/PMC9270753/
To describe and analyze the predictive models of the prognosis of patients with hepatocellular carcinoma (HCC) undergoing systemic treatment. […] The systematic search yielded 42 eligible articles: 28 articles described the development of 28 prognostic models of patients with HCC treated with systemic therapy, and 14 articles described the external validation of 32 existing prognostic models of patients with HCC undergoing systemic treatment. […] This study describes and analyzes the prognostic models developed and validated for patients with HCC who have undergone systemic treatment. […] Although great progress has been made the treatment of advanced HCC, the overall prognosis of HCC after treatment remains poor. […] At present, many multivariable prognostic models predicting the clinical outcome of patients with HCC treated with systemic therapy have been developed, but whether their predictions are reliable is unclear.
#8 Prognostic models for outcome prediction in patients with advanced hepatocellular carcinoma treated by systemic therapy: a systematic review and critical appraisal | BMC Cancer | Full Text
https://bmccancer.biomedcentral.com/articles/10.1186/s12885-022-09841-5
To describe and analyze the predictive models of the prognosis of patients with hepatocellular carcinoma (HCC) undergoing systemic treatment. […] The systematic search yielded 42 eligible articles: 28 articles described the development of 28 prognostic models of patients with HCC treated with systemic therapy, and 14 articles described the external validation of 32 existing prognostic models of patients with HCC undergoing systemic treatment. […] This study describes and analyzes the prognostic models developed and validated for patients with HCC who have undergone systemic treatment. […] Although great progress has been made the treatment of advanced HCC, the overall prognosis of HCC after treatment remains poor. […] At present, many multivariable prognostic models predicting the clinical outcome of patients with HCC treated with systemic therapy have been developed, but whether their predictions are reliable is unclear.
#9 Prognostic models for outcome prediction in patients with advanced hepatocellular carcinoma treated by systemic therapy: a systematic review and critical appraisal
https://pmc.ncbi.nlm.nih.gov/articles/PMC9270753/
The most common clinical indicators for predicting the prognosis of patients with HCC after systemic treatment were OS and PFS. […] The most commonly used predictors were AFP (n=9), albumin (n=8), bilirubin (n=8), ChildPugh class (n=8), extrahepatic metastasis (n=7), tumor size (n=7), and vascular invasion (n=6). […] The most common indicators for evaluating the predictive performance of a prognostic model were discrimination and calibration. […] Thirty-two prognostic models were externally validated. […] The development and validation of these models will aid the identification of patients with HCC who may benefit from systemic therapy, and guide treatment. […] Future studies should focus on updating existing prognosis models by adjusting predictors to improve performance and promoting their clinical practice through external validation.
#10 Prognostic models for outcome prediction in patients with advanced hepatocellular carcinoma treated by systemic therapy: a systematic review and critical appraisal
https://pmc.ncbi.nlm.nih.gov/articles/PMC9270753/
The most common clinical indicators for predicting the prognosis of patients with HCC after systemic treatment were OS and PFS. […] The most commonly used predictors were AFP (n=9), albumin (n=8), bilirubin (n=8), ChildPugh class (n=8), extrahepatic metastasis (n=7), tumor size (n=7), and vascular invasion (n=6). […] The most common indicators for evaluating the predictive performance of a prognostic model were discrimination and calibration. […] Thirty-two prognostic models were externally validated. […] The development and validation of these models will aid the identification of patients with HCC who may benefit from systemic therapy, and guide treatment. […] Future studies should focus on updating existing prognosis models by adjusting predictors to improve performance and promoting their clinical practice through external validation.
#11 Prognostic models for outcome prediction in patients with advanced hepatocellular carcinoma treated by systemic therapy: a systematic review and critical appraisal | BMC Cancer | Full Text
https://bmccancer.biomedcentral.com/articles/10.1186/s12885-022-09841-5
The most common clinical indicators for predicting the prognosis of patients with HCC after systemic treatment were OS and PFS. […] The most commonly used predictors were AFP, albumin, bilirubin, ChildPugh class, liver metastasis, tumor size, and vascular invasion. […] The most commonly used and widely cited discrimination indicator is the concordance index (c-index or C statistic). […] Among the articles on the 28 prognostic models, 24 calculated the models C statistic. […] Thirty-two prognostic models were externally validated. […] The development and validation of these models will aid the identification of patients with HCC who may benefit from systemic therapy, and guide treatment. […] Future studies should focus on updating existing prognosis models by adjusting predictors to improve performance and promoting their clinical practice through external validation.
#12 Evaluation of models to predict prognosis in patients with advanced hepatocellular carcinoma treated with TACE combined with apatinib
https://pmc.ncbi.nlm.nih.gov/articles/PMC11003186/
The HAP, Six-and-Twelve, Up to Seven, and ALBI scores have been substantiated as reliable prognostic markers in patients presenting with intermediate and advanced hepatocellular carcinoma (HCC) undergoing transarterial chemoembolization (TACE) treatment. […] Our study confirms the predictive value of HAP, Six-and-Twelve, Up to Seven, and ALBI scores in intermediate to advanced Hepatocellular Carcinoma (HCC) patients receiving combined Transarterial Chemoembolization (TACE) and Apatinib therapy. Notably, the HAP model excels in predicting outcomes for this specific HCC subgroup. […] Cox proportional hazards model results revealed that the ALBI score, presence of portal vein tumor thrombus (PVTT, )and tumor size are independent determinants of prognostic survival. […] The study found that the ALBI score (Hazard Ratio (HR)=0.624, 95% Confidence Interval (CI) 0.4270.842, p=0.012) had an independent effect on overall survival. Furthermore, the presence of PVTT (HR=0.522, 95% CI 0.4530.732, p0.001) and the size of the tumor (HR=0.512, 95% CI 0.3610.723, p0.001) were also identified as independent risk factors for overall survival.
#13 Evaluation of models to predict prognosis in patients with advanced hepatocellular carcinoma treated with TACE combined with apatinib | BMC Gastroenterology | Full Text
https://bmcgastroenterol.biomedcentral.com/articles/10.1186/s12876-024-03210-1
The HAP, Six-and-Twelve, Up to Seven, and ALBI scores have been substantiated as reliable prognostic markers in patients presenting with intermediate and advanced hepatocellular carcinoma (HCC) undergoing transarterial chemoembolization (TACE) treatment. […] Our study confirms the predictive value of HAP, Six-and-Twelve, Up to Seven, and ALBI scores in intermediate to advanced Hepatocellular Carcinoma (HCC) patients receiving combined Transarterial Chemoembolization (TACE) and Apatinib therapy. Notably, the HAP model excels in predicting outcomes for this specific HCC subgroup. […] The importance of predictive value for survival duration was significant across four staging systems (P<0.001), with comprehensive results in Table 2. [...] The study found that the ALBI score (Hazard Ratio (HR)=0.624, 95% Confidence Interval (CI) 0.427-0.842, p=0.012) had an independent effect on overall survival. Furthermore, the presence of PVTT (HR=0.522, 95% CI 0.453-0.732, p<0.001) and the size of the tumor (HR=0.512, 95% CI 0.361-0.723, p<0.001) were also identified as independent risk factors for overall survival.
#14 Evaluation of models to predict prognosis in patients with advanced hepatocellular carcinoma treated with TACE combined with apatinib
https://pmc.ncbi.nlm.nih.gov/articles/PMC11003186/
Among the four scoring systems, the HAP model exhibited the highest C-index at 0.742, indicating superior survival predictive ability, followed by the Six-and-Twelve score (0.701), Up to seven score (0.698), and ALBI score (0.601). […] The HAP score presented higher AUC values than the other three scores in predicting OS at 6 months, 12 months, and 24 months.
#15 Evaluation of models to predict prognosis in patients with advanced hepatocellular carcinoma treated with TACE combined with apatinib | BMC Gastroenterology | Full Text
https://bmcgastroenterol.biomedcentral.com/articles/10.1186/s12876-024-03210-1
Among the four scoring systems, the HAP model exhibited the highest C-index at 0.742, indicating superior survival predictive ability, followed by the Six-and-Twelve score (0.701), Up to seven score (0.698), and ALBI score (0.601). […] The HAP score demonstrated commendable discriminatory abilities in predicting short-term survival at 6 months, 12 months, and 24 months. […] Our research shows that the HAP, Six-and-Twelve, Up to Seven, and ALBI scoring systems displayed excellent discriminatory abilities in this cohort. […] The HAP score emphasizes four factors concerning hepatic functional reserve and tumor burden, which may explain its superior predictive performance. […] The outcomes of our study emphasize the probable benefits of the amalgamation of TACE with Apatinib to cure intermediate and advanced HCC patients.
#16 Evaluation of models to predict prognosis in patients with advanced hepatocellular carcinoma treated with TACE combined with apatinib
https://pmc.ncbi.nlm.nih.gov/articles/PMC11003186/
The HAP, Six-and-Twelve, Up to Seven, and ALBI scores have been substantiated as reliable prognostic markers in patients presenting with intermediate and advanced hepatocellular carcinoma (HCC) undergoing transarterial chemoembolization (TACE) treatment. […] Our study confirms the predictive value of HAP, Six-and-Twelve, Up to Seven, and ALBI scores in intermediate to advanced Hepatocellular Carcinoma (HCC) patients receiving combined Transarterial Chemoembolization (TACE) and Apatinib therapy. Notably, the HAP model excels in predicting outcomes for this specific HCC subgroup. […] Cox proportional hazards model results revealed that the ALBI score, presence of portal vein tumor thrombus (PVTT, )and tumor size are independent determinants of prognostic survival. […] The study found that the ALBI score (Hazard Ratio (HR)=0.624, 95% Confidence Interval (CI) 0.4270.842, p=0.012) had an independent effect on overall survival. Furthermore, the presence of PVTT (HR=0.522, 95% CI 0.4530.732, p0.001) and the size of the tumor (HR=0.512, 95% CI 0.3610.723, p0.001) were also identified as independent risk factors for overall survival.
#17 Evaluation of models to predict prognosis in patients with advanced hepatocellular carcinoma treated with TACE combined with apatinib | BMC Gastroenterology | Full Text
https://bmcgastroenterol.biomedcentral.com/articles/10.1186/s12876-024-03210-1
The HAP, Six-and-Twelve, Up to Seven, and ALBI scores have been substantiated as reliable prognostic markers in patients presenting with intermediate and advanced hepatocellular carcinoma (HCC) undergoing transarterial chemoembolization (TACE) treatment. […] Our study confirms the predictive value of HAP, Six-and-Twelve, Up to Seven, and ALBI scores in intermediate to advanced Hepatocellular Carcinoma (HCC) patients receiving combined Transarterial Chemoembolization (TACE) and Apatinib therapy. Notably, the HAP model excels in predicting outcomes for this specific HCC subgroup. […] The importance of predictive value for survival duration was significant across four staging systems (P<0.001), with comprehensive results in Table 2. [...] The study found that the ALBI score (Hazard Ratio (HR)=0.624, 95% Confidence Interval (CI) 0.427-0.842, p=0.012) had an independent effect on overall survival. Furthermore, the presence of PVTT (HR=0.522, 95% CI 0.453-0.732, p<0.001) and the size of the tumor (HR=0.512, 95% CI 0.361-0.723, p<0.001) were also identified as independent risk factors for overall survival.
#18 Integrating Muscle Depletion with Barcelona Clinic Liver Cancer Staging to Predict Overall Survival in Hepatocellular Carcinoma
https://www.mdpi.com/2072-6694/17/1/24
Muscle depletion (MD), a key predictor of survival in hepatocellular carcinoma (HCC), is often excluded from current prognostic tools. […] This study aimed to evaluate the prognostic impact of MD on overall survival (OS) in HCC patients and to improve existing noninvasive prognostic models by incorporating MD-related metrics. […] The key independent predictors of OS in HCC patients included hepatitis B virus infection, hepatitis C virus infection, liver cirrhosis, tumor size, serum alpha-fetoprotein levels, and MD-related metrics (psoas muscle-to-spine ratio, psoas muscle-to-vertebral ratio, and myosteatosis). […] However, incorporating MD significantly improved the predictive accuracy of these models, with the MDâBCLC model showing the highest AUROC (0.804, 95% CI: 0.777â0.832, p < 0.001).
#19 Integrating Muscle Depletion with Barcelona Clinic Liver Cancer Staging to Predict Overall Survival in Hepatocellular Carcinoma
https://www.mdpi.com/2072-6694/17/1/24
Muscle depletion (MD), a key predictor of survival in hepatocellular carcinoma (HCC), is often excluded from current prognostic tools. […] This study aimed to evaluate the prognostic impact of MD on overall survival (OS) in HCC patients and to improve existing noninvasive prognostic models by incorporating MD-related metrics. […] The key independent predictors of OS in HCC patients included hepatitis B virus infection, hepatitis C virus infection, liver cirrhosis, tumor size, serum alpha-fetoprotein levels, and MD-related metrics (psoas muscle-to-spine ratio, psoas muscle-to-vertebral ratio, and myosteatosis). […] However, incorporating MD significantly improved the predictive accuracy of these models, with the MDâBCLC model showing the highest AUROC (0.804, 95% CI: 0.777â0.832, p < 0.001).
#20 Integrating Muscle Depletion with Barcelona Clinic Liver Cancer Staging to Predict Overall Survival in Hepatocellular Carcinoma
https://www.mdpi.com/2072-6694/17/1/24
MD is an independent and significant prognostic predictor for patients with HCC. Integrating MD metrics into established systems, particularly the BCLC staging system, markedly improves OS prediction, providing a more comprehensive tool for clinical decision-making in the management of HCC. […] The median OS was 26.2 months, and 771 (71.9%) patients died during follow-up. […] Patients with muscle depletion had shorter survival than those without [1.46 years, 95% CI: 1.12â1.77 vs. 4.29 years, 95% CI: 3.27â5.30, p < 0.001]. [...] In multivariate analysis, all these factors, except older age, were independent survival predictors for patients with HCC: [...] muscle depletion (aHR: 1.566, 95% CI: 1.351â1.814, p < 0.001). [...] The AUROC of the MDâALBI, MDâBCLC, and MDâCTP models was better than those of the individual components, with values of 0.694 (95% CI: 0.660â0.728), 0.804 (95% CI: 0.777â0.832), and 0.701 (95% CI: 0.668â0.734), respectively.
#21 Artificial intelligence in the detection, characterisation and prediction of hepatocellular carcinoma: a narrative review – Kawka – Translational Gastroenterology and Hepatology
https://tgh.amegroups.org/article/view/6429/html
Hepatocellular carcinoma (HCC) is a significant cause of morbidity and mortality worldwide. […] AI solutions for predicting treatment outcomes and survival emerged in recent years with the potential to shape future HCC guidelines. […] AI has potential to revolutionise detection, characterisation and prediction of HCC, however, for AI solutions to reach widespread clinical adoption, interdisciplinary collaboration is needed, to foster an environment in which AI solutions can be further improved, validated and included in treatment algorithms. […] AI algorithms were successfully developed to predict response to and survival after transarterial chemoembolization (TACE). […] AI methods for prediction of overall survival and treatment outcomes in HCC have emerged in the past two years and remain a dynamic area of study. […] AI will revolutionise the way we detect and characterise HCC, as well as predict the course of its development, however, it is still experimental.
#22 Artificial intelligence in the detection, characterisation and prediction of hepatocellular carcinoma: a narrative review – Kawka – Translational Gastroenterology and Hepatology
https://tgh.amegroups.org/article/view/6429/html
Hepatocellular carcinoma (HCC) is a significant cause of morbidity and mortality worldwide. […] AI solutions for predicting treatment outcomes and survival emerged in recent years with the potential to shape future HCC guidelines. […] AI has potential to revolutionise detection, characterisation and prediction of HCC, however, for AI solutions to reach widespread clinical adoption, interdisciplinary collaboration is needed, to foster an environment in which AI solutions can be further improved, validated and included in treatment algorithms. […] AI algorithms were successfully developed to predict response to and survival after transarterial chemoembolization (TACE). […] AI methods for prediction of overall survival and treatment outcomes in HCC have emerged in the past two years and remain a dynamic area of study. […] AI will revolutionise the way we detect and characterise HCC, as well as predict the course of its development, however, it is still experimental.
#23
https://link.springer.com/article/10.1007/s00330-024-10581-2
To develop and validate a risk scoring scale model (RSSM) for stratifying prognostic risk after intra-arterial therapies (IATs) for hepatocellular carcinoma (HCC). […] The CatBoost model achieved the best discrimination when 12 top variables were input, with the AUC of 0.851 (95% confidence intervals (CI), 0.8330.868) for TD, 0.817 (95%CI, 0.7590.857) for ITD, and 0.791 (95%CI, 0.7480.834) for ETD. […] The RSSM can stratify accurately prognostic risk for HCC patients received IAT. […] The risk scoring scale model could be easily implemented for physicians to stratify risk and predict prognosis quickly and accurately, thereby serving as a more favorable tool to strengthen individualized intra-arterial therapies and management in patients with unresectable hepatocellular carcinoma. […] We constructed an RSSM using six variables, including ICI (HR, 0.678; 95%CI 0.549, 0.837), TKI (HR, 0.702; 95%CI 0.605, 0.814), local therapy (HR, 0.104; 95%CI 0.014, 0.747), response to the first IAT (HR, 4.221; 95%CI 2.229, 7.994), tumor size (HR, 1.054; 95%CI 1.038, 1.070), and BCLC grade (HR, 2.375; 95%CI 1.950, 2.894) based CatBoost model.
#24 Survival statistics for liver cancer | Canadian Cancer Society
https://cancer.ca/en/cancer-information/cancer-types/liver/prognosis-and-survival/survival-statistics
Survival statistics for liver cancer are very general estimates and must be interpreted very carefully. Because these statistics are based on the experience of groups of people, they cannot be used to predict a particular person’s chances of survival. […] In Canada, the 5-year net survival for liver cancer is 22%. This means that, on average, about 22% of people diagnosed with liver cancer will survive for at least 5 years. […] Survival by stage of liver cancer is usually reported as median survival. Median survival is the length of time (usually months or years) after diagnosis or the start of treatment at which half of the people with this type of cancer are still alive. The other half will not live as long. […] A 5-year survival is 50% to 70%, if treated with liver resection, liver transplant or RFA.
#25 Survival statistics for liver cancer | Canadian Cancer Society
https://cancer.ca/en/cancer-information/cancer-types/liver/prognosis-and-survival/survival-statistics
Survival statistics for liver cancer are very general estimates and must be interpreted very carefully. Because these statistics are based on the experience of groups of people, they cannot be used to predict a particular person’s chances of survival. […] In Canada, the 5-year net survival for liver cancer is 22%. This means that, on average, about 22% of people diagnosed with liver cancer will survive for at least 5 years. […] Survival by stage of liver cancer is usually reported as median survival. Median survival is the length of time (usually months or years) after diagnosis or the start of treatment at which half of the people with this type of cancer are still alive. The other half will not live as long. […] A 5-year survival is 50% to 70%, if treated with liver resection, liver transplant or RFA.
#26 Liver Cancer: Symptoms, Signs, Causes & Treatment
https://my.clevelandclinic.org/health/diseases/9418-liver-cancer
Further, researchers break down survival rates by cancer stage. The five-year survival rate for early-stage (stage I or stage II) liver cancer is 37%. That survival rate drops to 13% for stage III liver cancer and 3% for stage IV liver cancer. […] Remember, cancer survival rates are estimates based on other peoples experience with certain kinds of cancer. Your situation may be different. Talk to your oncologist if you have questions about what survival rate information means for you.
#27 Survival statistics for liver cancer | Canadian Cancer Society
https://cancer.ca/en/cancer-information/cancer-types/liver/prognosis-and-survival/survival-statistics
Survival statistics for liver cancer are very general estimates and must be interpreted very carefully. Because these statistics are based on the experience of groups of people, they cannot be used to predict a particular person’s chances of survival. […] In Canada, the 5-year net survival for liver cancer is 22%. This means that, on average, about 22% of people diagnosed with liver cancer will survive for at least 5 years. […] Survival by stage of liver cancer is usually reported as median survival. Median survival is the length of time (usually months or years) after diagnosis or the start of treatment at which half of the people with this type of cancer are still alive. The other half will not live as long. […] A 5-year survival is 50% to 70%, if treated with liver resection, liver transplant or RFA.
#28 Survival statistics for liver cancer | Canadian Cancer Society
https://cancer.ca/en/cancer-information/cancer-types/liver/prognosis-and-survival/survival-statistics
Survival statistics for liver cancer are very general estimates and must be interpreted very carefully. Because these statistics are based on the experience of groups of people, they cannot be used to predict a particular person’s chances of survival. […] In Canada, the 5-year net survival for liver cancer is 22%. This means that, on average, about 22% of people diagnosed with liver cancer will survive for at least 5 years. […] Survival by stage of liver cancer is usually reported as median survival. Median survival is the length of time (usually months or years) after diagnosis or the start of treatment at which half of the people with this type of cancer are still alive. The other half will not live as long. […] A 5-year survival is 50% to 70%, if treated with liver resection, liver transplant or RFA.
#29 Survival statistics for liver cancer | Canadian Cancer Society
https://cancer.ca/en/cancer-information/cancer-types/liver/prognosis-and-survival/survival-statistics
Median survival is 16 months. It may increase to 40 months with transarterial chemoembolization (TACE). […] Median survival is 11 to 13 months with treatment and 6 to 8 months without treatment. […] Median survival is 3 to 4 months. […] Only a doctor familiar with these factors can put all of this information together with survival statistics to arrive at a prognosis.
#30 Liver Cancer Survival Rates | American Cancer Society | American Cancer Society
https://www.cancer.org/cancer/types/liver-cancer/detection-diagnosis-staging/survival-rates.html
The SEER database tracks 5-year relative survival rates for liver cancer in the United States, based on how far the cancer has spread. […] In general, survival rates are higher for people who can have surgery to remove their cancer, regardless of the stage. For example, studies have shown that patients with small, resectable (removable) tumors who do not have cirrhosis or other serious health problems are likely to do well if their cancers are removed. For people with early-stage liver cancers who have a liver transplant, the 5-year survival rate is in the range of 60% to 70%. […] People now being diagnosed with liver cancer may have a better outlook than these numbers show. Treatments improve over time, and these numbers are based on people who were diagnosed and treated at least five years earlier.
#31 Liver Cancer: Symptoms, Signs, Causes & Treatment
https://my.clevelandclinic.org/health/diseases/9418-liver-cancer
Successful liver transplants can cure liver cancer. But not everyone who needs a liver transplant can receive one. For example, they may not be healthy enough to go through a transplant. And it can be difficult to find a donated liver thats a match. […] Researchers are making progress on liver cancer treatment so people can live longer. But liver cancer remains a life-threatening disease. How long youll live with liver cancer depends on factors like the cancer stage, how you respond to treatment and your health. […] Data show that 21% of people with HCC or ICC are alive five years after their diagnosis. A relative survival rate compares two sets of five-year survival rates. One rate is the percentage of people with a specific disease. The other rate is people who dont have the disease. In this case, 21% of people with HCC or ICC were alive five years after their diagnosis. By comparison, 79% of people in the general population were alive after that same time.
#32 Development and validation of personalised risk prediction models for early detection and diagnosis of primary liver cancer among the English primary care population using the QResearchÂ® database: research protocol and statistical analysis plan | medRxiv
https://www.medrxiv.org/content/10.1101/2022.01.24.22269755v1.full-text
The incidence and mortality of liver cancer have been increasing in recent years in the UK. […] Compared with other cancers, the prognosis of liver cancer is poor, with respective 1- and 5-year survival estimates of only 38.1% and 12.7% in England during 2013-2017. […] Early diagnosis is associated with better survival. When it is diagnosed at its earliest stage, 78% of people can survive for one year or longer, compared with 20% when diagnosed at the latest stage. […] Risk prediction models to estimate an individual patients future risk of developing liver cancer would enhance early detection and diagnosis (EDD) of liver cancer in the English population, and could inform screening and prevention strategies. […] This study aims to generate new knowledge for early detection and diagnosis of primary liver cancer from the English population, with a special interest in HCC.
#33 Development and validation of personalised risk prediction models for early detection and diagnosis of primary liver cancer among the English primary care population using the QResearchÂ® database: research protocol and statistical analysis plan | medRxiv
https://www.medrxiv.org/content/10.1101/2022.01.24.22269755v1.full-text
The incidence and mortality of liver cancer have been increasing in recent years in the UK. […] Compared with other cancers, the prognosis of liver cancer is poor, with respective 1- and 5-year survival estimates of only 38.1% and 12.7% in England during 2013-2017. […] Early diagnosis is associated with better survival. When it is diagnosed at its earliest stage, 78% of people can survive for one year or longer, compared with 20% when diagnosed at the latest stage. […] Risk prediction models to estimate an individual patients future risk of developing liver cancer would enhance early detection and diagnosis (EDD) of liver cancer in the English population, and could inform screening and prevention strategies. […] This study aims to generate new knowledge for early detection and diagnosis of primary liver cancer from the English population, with a special interest in HCC.
#34 Circulating levels of microRNA193a-5p predict outcome in early stage hepatocellular carcinoma | PLOS One
https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0239386
Circulating relative miR-193a-5p levels were significantly elevated in HCC patients compared to healthy controls. […] High relative miR-193a-5p levels were predictive for the patients postoperative outcome, which was confirmed in uni- and multivariate Cox-regression analysis. […] HCC patients with a preoperative relative miR-193a-5p level above the ideal cut-off value (3.57) had a median overall survival (OS) of only 451 days compared to 1158 days in patients with a relative miR-193a-5p level below this cut-off value. […] Elevated levels of circulating miR-193a-5p predict an impaired outcome. […] The median OS was only 451 days for the subgroup of patients showing high relative miR-193a-5p levels compared to 1158 days in those patients with a relative miR-193a-5p level below the ideal cut-off value.
#35 Circulating levels of microRNA193a-5p predict outcome in early stage hepatocellular carcinoma | PLOS One
https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0239386
Importantly, relative circulating miR-193a-5p levels turned out as an independent prognostic marker for OS. […] Our data should encourage further multi-center clinical trials including larger patient numbers in different disease stages to provide clearer answers regarding a potential use of miR-193a-5p as a clinical marker in the context of HCC.
#36 Spatial patterns and MRI-based radiomic prediction of high peritumoral tertiary lymphoid structure density in hepatocellular carcinoma: a multicenter study | Journal for ImmunoTherapy of Cancer
https://jitc.bmj.com/content/12/12/e009879
Patients with HCC and a high pTLS density experienced prolonged median overall survival (p0.05) and favorable immunotherapy response (p=0.03). […] We identified key regulators of pTLS density in patients with HCC and proposed a non-invasive radiomic classifier capable of assisting in stratification for prognosis and treatment. […] High pTLS density group significantly correlated with improved overall survival (OS) and relapse-free survival (RFS) (both log-rank p0.05) in the TCGA-LIHC (n=363) and in-house (n=660) cohorts. […] The predicted pTLShigh group exhibited prolonged mST for OS (HR 0.200.44, p=0.005to 0.001) and RFS (HR 0.250.73, p=0.015to 0.001) compared with predicted pTLSlow group across three data sets. […] Our study identifies potential novel targets of pTLS density, shedding light on its clinical application in immunotherapy. Developing a non-invasive method for assessing pTLS density could aid in clinical decision-making and treatment selection in hepatocellular carcinoma.
#37 Spatial patterns and MRI-based radiomic prediction of high peritumoral tertiary lymphoid structure density in hepatocellular carcinoma: a multicenter study | Journal for ImmunoTherapy of Cancer
https://jitc.bmj.com/content/12/12/e009879
Patients with HCC and a high pTLS density experienced prolonged median overall survival (p0.05) and favorable immunotherapy response (p=0.03). […] We identified key regulators of pTLS density in patients with HCC and proposed a non-invasive radiomic classifier capable of assisting in stratification for prognosis and treatment. […] High pTLS density group significantly correlated with improved overall survival (OS) and relapse-free survival (RFS) (both log-rank p0.05) in the TCGA-LIHC (n=363) and in-house (n=660) cohorts. […] The predicted pTLShigh group exhibited prolonged mST for OS (HR 0.200.44, p=0.005to 0.001) and RFS (HR 0.250.73, p=0.015to 0.001) compared with predicted pTLSlow group across three data sets. […] Our study identifies potential novel targets of pTLS density, shedding light on its clinical application in immunotherapy. Developing a non-invasive method for assessing pTLS density could aid in clinical decision-making and treatment selection in hepatocellular carcinoma.
#38 A novel Cuproptosis-related LncRNA signature to predict prognosis in hepatocellular carcinoma | Scientific Reports
https://www.nature.com/articles/s41598-022-15251-1
Increased intracellular toxicity due to an imbalance in copper homeostasis caused by copper ion accumulation could regulate the rate of cancer cell growth and proliferation. […] The goal of this study was to create a novel Cuproptosis-related lncRNA signature that may be utilized to predict survival and immunotherapy in HCC patients. […] By LASSO-Cox analysis, the overlapping lncRNAs were then utilized to build a Cuproptosis-associated lncRNA signature, which might be used to predict patient prognosis and responsiveness to immune checkpoint blockade (ICB) therapy. […] Moreover, a nomogram based on the Cuproptosis-associated lncRNA signature and clinical features was developed and demonstrated to have good predictive potential. […] In summary, we created a prognostic lncRNA profile linked to Cuproptosis to forecast response to immunotherapy, which may provide a new potential non-apoptotic therapeutic perspective for HCC patients.
#39 A novel Cuproptosis-related LncRNA signature to predict prognosis in hepatocellular carcinoma | Scientific Reports
https://www.nature.com/articles/s41598-022-15251-1
The high expression of these five genes was also closely associated with poor prognosis in HCC patients. […] Furthermore, the results of the ssGSEA analysis showed that patients with higher Cuproptosis Z-scores had shorter survival times. […] These all suggested the involvement of Cuproptosis in the prognostic development of HCC patients. […] A total of 16 candidate lncRNA with a P value less than 0.05 were identified to be associated with the patient’s prognosis. […] We found that patients with lower risk scores had a better survival outcome in both the training cohort, the testing cohort, and the TCGA cohort. […] According to time-ROC analysis, this signature has a great predictive ability, with AUCs of 0.739, 0.725, and 0.734 in the training cohort, 0.709, 0.708, and 0.698 in the testing cohort, and 0.716, 0.708, 0.719 in TCGA cohort at one, three, and five years, respectively.
#40 A novel Cuproptosis-related LncRNA signature to predict prognosis in hepatocellular carcinoma | Scientific Reports
https://www.nature.com/articles/s41598-022-15251-1
The high expression of these five genes was also closely associated with poor prognosis in HCC patients. […] Furthermore, the results of the ssGSEA analysis showed that patients with higher Cuproptosis Z-scores had shorter survival times. […] These all suggested the involvement of Cuproptosis in the prognostic development of HCC patients. […] A total of 16 candidate lncRNA with a P value less than 0.05 were identified to be associated with the patient’s prognosis. […] We found that patients with lower risk scores had a better survival outcome in both the training cohort, the testing cohort, and the TCGA cohort. […] According to time-ROC analysis, this signature has a great predictive ability, with AUCs of 0.739, 0.725, and 0.734 in the training cohort, 0.709, 0.708, and 0.698 in the testing cohort, and 0.716, 0.708, 0.719 in TCGA cohort at one, three, and five years, respectively.
#41 Liver Cancer: Symptoms, Signs, Causes & Treatment
https://my.clevelandclinic.org/health/diseases/9418-liver-cancer
Successful liver transplants can cure liver cancer. But not everyone who needs a liver transplant can receive one. For example, they may not be healthy enough to go through a transplant. And it can be difficult to find a donated liver thats a match. […] Researchers are making progress on liver cancer treatment so people can live longer. But liver cancer remains a life-threatening disease. How long youll live with liver cancer depends on factors like the cancer stage, how you respond to treatment and your health. […] Data show that 21% of people with HCC or ICC are alive five years after their diagnosis. A relative survival rate compares two sets of five-year survival rates. One rate is the percentage of people with a specific disease. The other rate is people who dont have the disease. In this case, 21% of people with HCC or ICC were alive five years after their diagnosis. By comparison, 79% of people in the general population were alive after that same time.
#42 Liver Cancer Survival Rates | American Cancer Society | American Cancer Society
https://www.cancer.org/cancer/types/liver-cancer/detection-diagnosis-staging/survival-rates.html
The SEER database tracks 5-year relative survival rates for liver cancer in the United States, based on how far the cancer has spread. […] In general, survival rates are higher for people who can have surgery to remove their cancer, regardless of the stage. For example, studies have shown that patients with small, resectable (removable) tumors who do not have cirrhosis or other serious health problems are likely to do well if their cancers are removed. For people with early-stage liver cancers who have a liver transplant, the 5-year survival rate is in the range of 60% to 70%. […] People now being diagnosed with liver cancer may have a better outlook than these numbers show. Treatments improve over time, and these numbers are based on people who were diagnosed and treated at least five years earlier.
#43 Hepatocellular carcinoma | Nature Reviews Disease Primers
https://www.nature.com/articles/s41572-020-00240-3
Liver cancer remains a global health challenge, with an estimated incidence of 1 million cases by 2025. Hepatocellular carcinoma (HCC) is the most common form of liver cancer and accounts for ~90% of cases. […] Approximately 25% of all HCCs present with potentially actionable mutations, which are yet to be translated into the clinical practice. […] The current major advancements have impacted the management of patients with advanced HCC. […] The outcomes of these trials are expected to change the landscape of HCC management at all evolutionary stages. […] This study is the first molecular indication of the importance of the cancer field effect in the outcome of patients with HCC. […] This paper is a meta-analysis defining the accuracy of distinct surveillance strategies for the early detection of HCC.
#44 Hepatocellular carcinoma | Nature Reviews Disease Primers
https://www.nature.com/articles/s41572-020-00240-3
The chances of hepatic resection curing hepatocellular carcinoma. […] The role of hepatic resection in the treatment of hepatocellular cancer. […] The ALBI grade provides objective hepatic reserve estimation across each BCLC stage of hepatocellular carcinoma. […] The role of telomeres and telomerase in cirrhosis and liver cancer. […] The immunology of hepatocellular carcinoma. […] The first study demonstrating survival benefit for systemic therapies (sorafenib) in advanced HCC compared with placebo. […] The first study demonstrating survival benefit in second-line treatment for patients with advanced HCC progressing to sorafenib therapy.
#45 Hepatocellular carcinoma | Nature Reviews Disease Primers
https://www.nature.com/articles/s41572-020-00240-3
Liver cancer remains a global health challenge, with an estimated incidence of 1 million cases by 2025. Hepatocellular carcinoma (HCC) is the most common form of liver cancer and accounts for ~90% of cases. […] Approximately 25% of all HCCs present with potentially actionable mutations, which are yet to be translated into the clinical practice. […] The current major advancements have impacted the management of patients with advanced HCC. […] The outcomes of these trials are expected to change the landscape of HCC management at all evolutionary stages. […] This study is the first molecular indication of the importance of the cancer field effect in the outcome of patients with HCC. […] This paper is a meta-analysis defining the accuracy of distinct surveillance strategies for the early detection of HCC.