Reduction in Non-Protein Respiratory Quotient Is Related to Overall Survival after Hepatocellular Carcinoma TreatmentReport as inadecuate




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Background

Transcatheter arterial chemoembolization TACE is an effective treatment for hepatocellular carcinoma HCC that can occasionally lead to the shortening of life expectancy. We aimed to make a new and more accurate prognostic model taking into account the course of disease after TACE.

Methodology-Principal Findings

We performed a prospective cohort study involving 100 HCC patients who underwent TACE at Kobe University Hospital. Indirect calorimetry and blood biochemical examinations were performed before and 7 days after TACE. Time-dependent and time-fixed factors associated with 1-year mortality after TACE were assessed by multivariate analyses. A predictive model of 1-year mortality was established by the combination of odds ratios of these factors. Multivariate analyses showed that the ratio of non-protein respiratory quotient npRQ 7 days after-before TACE and Cancer of Liver Italian Program CLIP score were independent factors of 1-year mortality after TACE p = 0.014 and 0.013, respectively. Patient-specific 1-year mortality risk scores can be calculated by summarizing the individual risk scores and looking up the patient-specific risk on the graph.

Conclusions

The short-term reduction of npRQ was a time-dependent prognostic factor associated with overall survival in HCC patients undergoing TACE. CLIP score was a time-fixed prognostic factor associated with overall survival. Using the prediction model, which consists of the combination of time-dependent npRQ ratio and time-fixed CLIP score prognostic factors, 1-year mortality risk after TACE would be better estimated by taking into account changes during the course of disease.



Author: Masaya Saito, Yasushi Seo, Yoshihiko Yano, Kenji Momose, Hirotaka Hirano, Masaru Yoshida, Takeshi Azuma

Source: http://plos.srce.hr/



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