Z Gastroenterol 2020; 58(08): e165
DOI: 10.1055/s-0040-1716173
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Prognostic score utilizing glypican-3 serum levels for the prediction of 6-month outcome after transarterial therapies for patients with intermediate stage hepatocellular carcinoma

A Olbrich
1   Leipzig University Medical Center, Division of Hepatology, Department of Oncology, Gastroenterology, Hepatology, Pulmonology, and Infectious Diseases, Leipzig, Deutschland
,
O Gros
2   Helios Clinic Köthen, Department of Anesthesia and Intensive Care, Köthen, Deutschland
,
F Lordick
3   Leipzig University Medical Center, University Cancer Center Leipzig (UCCL), Leipzig, Deutschland
,
D Forstmeyer
3   Leipzig University Medical Center, University Cancer Center Leipzig (UCCL), Leipzig, Deutschland
,
R Sucher
4   Leipzig University Medical Center, Department of Visceral, Vascular, Thoracic and Transplant Surgery, Leipzig, Deutschland
,
D Seehofer
4   Leipzig University Medical Center, Department of Visceral, Vascular, Thoracic and Transplant Surgery, Leipzig, Deutschland
,
Petersen TO
5   Clinic St. Elisabeth and St. Barbara Hospital Halle, Clinic for Diagnostic and Interventional Radiology, Halle, Deutschland
,
B Maiwald
5   Clinic St. Elisabeth and St. Barbara Hospital Halle, Clinic for Diagnostic and Interventional Radiology, Halle, Deutschland
,
T Berg
1   Leipzig University Medical Center, Division of Hepatology, Department of Oncology, Gastroenterology, Hepatology, Pulmonology, and Infectious Diseases, Leipzig, Deutschland
,
F van Bömmel
1   Leipzig University Medical Center, Division of Hepatology, Department of Oncology, Gastroenterology, Hepatology, Pulmonology, and Infectious Diseases, Leipzig, Deutschland
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The selection of patients with intermediate stage hepatocellular carcinoma (HCC) for transarterial therapies currently relies on liver function and tumor properties. Outcome prediction by circulating biomarker is desirable, but not established. The aim of this study was to assess experimental HCC biomarkers for their association with survival after transarterial therapies.

Data were retrospectively collected from 125 consecutive HCC patients with intermediate stage HCC (BCLC-B) undergoing either transarterial chemoembolization (TACE, n=98) and/or selective internal radiation therapy (SIRT, n=28) at one German University Hospital between 2010 and 2017. Patients and tumor characteristics including total diameter and number of tumor lesions, C-reactive protein (CRP), platelets, leucocyte counts, albumin, bilirubin and alanine transaminase (ALT) levels as well as circulating HCC biomarkers including AFP, AFP-L3, des-gamma-carboxy prothrombin (DCP), alone and summarized in the GALAD score, glypican-3 (GPC-3), and Dickkopf-related protein 1 (Dkk-1) were quantified on cryopreserved serum samples taken prior to therapy.

Univariate analyses showed that lower GPC-3 as well as DCP serum levels were significantly associated with 6-month survival. Moreover, higher GALAD-scores were associated with a poorer prognosis. In contrast, all other patient and tumor related parameters showed no significant difference regarding 6-month survival. By multivariate analysis, the biomarkers with the highest association with treatment response were GPC-3, the number of lesions and CRP. A combination of these three markers in a new prognostic score GLC (GLC = 2.873 - 2.161/100 * GPC-3 (pg/ml) - 0.185 * number of lesions - 0.052 * CRP (mg/l)) was developed resulting in a specificity of 72.7 % and sensitivity of 77.9 % for prediction of 6-month-survival.

The combination of novel HCC biomarkers might be a potent tool for tailoring individualized treatment strategies for patients with intermediate stage HCC. The GLC-Score can help to estimate the 6-month-survival rate of these patients with high sensitivity and specificity.



Publication History

Article published online:
08 September 2020

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