アリイズミ　シユンイチ   ARIIZUMI Shunichi   有泉　俊一    所属   医学部 医学科（東京女子医科大学病院）    職種   准教授
論文種別	原著
言語種別	英語
査読の有無	査読なし
表題	Des-gamma-carboxy prothrombin affects the survival of HCC patients with marginal liver function and curative treatment: ACRoS1402.
掲載誌名	正式名：Journal of cancer research and clinical oncology 略　 称：J Cancer Res Clin Oncol ISSNコード：14321335/01715216
掲載区分	国外
巻・号・頁	146(11),pp.2949-2956
著者・共著者	Kudo Atsushi, Shinoda Masahiro, Ariizumi Shunichi, Kumamoto Takafumi, Katayama Masafumi, Otsubo Takehito, Endo Itaru, Kitagawa Yuko, Tanabe Minoru, Yamamoto Masakazu,
発行年月	2020/11
概要	PURPOSE:Considering the initial treatment of hepatocellular carcinoma (HCC), the best prognostic index for Child-Pugh classes B and C (CP-BC) patients has not been yet established. This study aimed to elucidate the risk factors for disease-free survival (DFS) and overall survival (OS) in multicenter patients with a poor liver functional reserve after curative treatment.METHODS:Between April 2000 and April 2014, 212 CP-BC patients who received treatment in five high-volume centers in Japan were included in this study. CP-B and C patients were 206 and 6, respectively. Cox proportional hazard regression analyses for DFS and OS were performed to estimate the risk factors.RESULTS:The mean observation time was 1132 days. Mean Child-Pugh score and indocyanine green retention rate at 15 min were 7.5 and 31.5%, respectively. Histological chronic hepatitis and liver cirrhosis were observed in 20% and 74% patients, respectively. In the multivariate analysis, the risk factors for DFS were des-gamma-carboxy prothrombin (DCP) [hazard ratio (HR), 1.6; P = 0.012] and treatment without liver transplantation. Moreover, DCP was identified as an independent risk factor for OS (HR, 1.7; P = 0.01). Tumor size, number, tumor thrombus, Milan criteria, liver cirrhosis, and treatment without liver transplantation were not identified as risk factors for OS. The 5-year OS in patients with high serum DCP levels (< 90 mAU/mL) was significantly better than that in those with low serum DCP levels (P = 0.003).CONCLUSIONS:Serum DCP value before treatment predicted both DFS and OS in CP-BC patients with HCC.
DOI	10.1007/s00432-020-03270-2
PMID	32462296