METHODS： Between December 2006 and June 2008, a total of 524 transfusion-associated HCV-RNA positive patients with or without HCC were enrolled, Liver stiffness was obtained noninvasively by using Fibroscan （Echosen...METHODS： Between December 2006 and June 2008, a total of 524 transfusion-associated HCV-RNA positive patients with or without HCC were enrolled, Liver stiffness was obtained noninvasively by using Fibroscan （Echosens, Paris, France）, The date of blood transfusion was obtained by interview, Duration of infection was derived from the interval between the date of bloodtransfusion and the date of liver stiffness measurement （LSM）. Patients were stratified into four groups based on the duration of infection （17-29 years; 30-39 years; 40-49 years; and 50-70 years）. The difference in liver stiffness between patients with and without HCC was assessed in each group. Multiple linear regression analysis was used to determine the factors associated with liver stiffness.RESULTS： A total of 524 patients underwent LSM. Eight patients were excluded because of unsuccessful measurements. Thus 516 patients were included in the current analysis （225 with HCC and 291 without）. The patients were 244 men and 272 women, with a mean age of 67.8 ±9.5 years. The median liver stiffness was 14.3 kPa （25.8 in HCC group and 7.6 in non HCC group）. The patients who developed HCC in short duration of infection were male dominant, having lower platelet count, with a history of heavier alcohol consumption, showing higher liver stiffness, and receiving blood transfusion at an old age. Liver stiffness was positively correlated with duration of infection in patients without HCC （r = 0.132, P = 0.024） but not in patients with HCC （r = -0.103, P = 0.123）. Liver stiffness was significantly higher in patients with HCC than in those without in each duration group （P 〈 0.0001）. The factors significantly associated with high liver stiffness in multiple regression were age at blood transfusion （P 〈 0.0001）, duration of infection （P = 0.0015）, and heavy alcohol consumption （P = 0.043）CONCLUSION： Although liver stiffness gradually increases over time, HCC develops in patients with high stiffness value regardless of the duration of infection.展开更多
Background and aims:Lenvatinib(LEN)is a newly developed tyrosine kinase inhibitor,and is approved as a first-line treatment for advanced hepatocellular carcinoma(HCC)in Japan.This retrospective multi-center study inve...Background and aims:Lenvatinib(LEN)is a newly developed tyrosine kinase inhibitor,and is approved as a first-line treatment for advanced hepatocellular carcinoma(HCC)in Japan.This retrospective multi-center study investigated the effect of the relative dose intensity(RDI)of LEN on response rate,progression-free survival(PFS),and overall survival(OS).Methods:This retrospective study enrolled 123 patients with advanced HCC who were treated with LEN at six hospitals in Japan between March 2018 and December 2019.These patients were divided into two groups:RDI≥70%(RDI 70 group,N=70)or RDI<70%(control group,N=53)in the first 30 days.The following data were compared between groups:patient backgrounds,adverse events,treatment out-comes,PFS,and OS.PFS and OS were analyzed using the Kaplan-Meier method,followed by the log-rank test.To identify significant factors that contributed to response,PFS,and OS,multivariate analysis was performed using factors for which P-values were<0.10 in univariate analysis.Results:The proportion of patients with Child-Pugh class 5A was significantly greater in the RDI 70 group than that in the control group(64.3%vs.28.3%,P<0.01).Dose interruption due to adverse events was significantly more common in the control group.The response rate was significantly higher in the RDI 70 group than that in the control group(35.7%vs.11.3%,P<0.01).Median PFS was significantly longer in the RDI 70 group(9.4 vs.4.7 months,P<0.01).Multivariate analysis showed that RDI≥70%(hazard ratio(HR)=0.55,P=0.025),hypertension grade≥2(HR=0.47,P=0.019),and response(HR=0.52,P=0.033)were independently associated with improved PFS.Median OS was also significantly longer in the RDI 70 group(20.0 vs.13.3 months,P=0.045).Multivariate analysis showed that female sex(HR=0.33,P=0.034)and disease control(HR=0.31,P<0.01)were independently associated with improved OS.RDI≥70%was not statistically significant in multivariate analysis.Conclusions:Our study revealed the importance of achieving RDI≥70%in the first 30 days of treatment to maximize the effects of LEN。展开更多
文摘METHODS： Between December 2006 and June 2008, a total of 524 transfusion-associated HCV-RNA positive patients with or without HCC were enrolled, Liver stiffness was obtained noninvasively by using Fibroscan （Echosens, Paris, France）, The date of blood transfusion was obtained by interview, Duration of infection was derived from the interval between the date of bloodtransfusion and the date of liver stiffness measurement （LSM）. Patients were stratified into four groups based on the duration of infection （17-29 years; 30-39 years; 40-49 years; and 50-70 years）. The difference in liver stiffness between patients with and without HCC was assessed in each group. Multiple linear regression analysis was used to determine the factors associated with liver stiffness.RESULTS： A total of 524 patients underwent LSM. Eight patients were excluded because of unsuccessful measurements. Thus 516 patients were included in the current analysis （225 with HCC and 291 without）. The patients were 244 men and 272 women, with a mean age of 67.8 ±9.5 years. The median liver stiffness was 14.3 kPa （25.8 in HCC group and 7.6 in non HCC group）. The patients who developed HCC in short duration of infection were male dominant, having lower platelet count, with a history of heavier alcohol consumption, showing higher liver stiffness, and receiving blood transfusion at an old age. Liver stiffness was positively correlated with duration of infection in patients without HCC （r = 0.132, P = 0.024） but not in patients with HCC （r = -0.103, P = 0.123）. Liver stiffness was significantly higher in patients with HCC than in those without in each duration group （P 〈 0.0001）. The factors significantly associated with high liver stiffness in multiple regression were age at blood transfusion （P 〈 0.0001）, duration of infection （P = 0.0015）, and heavy alcohol consumption （P = 0.043）CONCLUSION： Although liver stiffness gradually increases over time, HCC develops in patients with high stiffness value regardless of the duration of infection.
文摘Background and aims:Lenvatinib(LEN)is a newly developed tyrosine kinase inhibitor,and is approved as a first-line treatment for advanced hepatocellular carcinoma(HCC)in Japan.This retrospective multi-center study investigated the effect of the relative dose intensity(RDI)of LEN on response rate,progression-free survival(PFS),and overall survival(OS).Methods:This retrospective study enrolled 123 patients with advanced HCC who were treated with LEN at six hospitals in Japan between March 2018 and December 2019.These patients were divided into two groups:RDI≥70%(RDI 70 group,N=70)or RDI<70%(control group,N=53)in the first 30 days.The following data were compared between groups:patient backgrounds,adverse events,treatment out-comes,PFS,and OS.PFS and OS were analyzed using the Kaplan-Meier method,followed by the log-rank test.To identify significant factors that contributed to response,PFS,and OS,multivariate analysis was performed using factors for which P-values were<0.10 in univariate analysis.Results:The proportion of patients with Child-Pugh class 5A was significantly greater in the RDI 70 group than that in the control group(64.3%vs.28.3%,P<0.01).Dose interruption due to adverse events was significantly more common in the control group.The response rate was significantly higher in the RDI 70 group than that in the control group(35.7%vs.11.3%,P<0.01).Median PFS was significantly longer in the RDI 70 group(9.4 vs.4.7 months,P<0.01).Multivariate analysis showed that RDI≥70%(hazard ratio(HR)=0.55,P=0.025),hypertension grade≥2(HR=0.47,P=0.019),and response(HR=0.52,P=0.033)were independently associated with improved PFS.Median OS was also significantly longer in the RDI 70 group(20.0 vs.13.3 months,P=0.045).Multivariate analysis showed that female sex(HR=0.33,P=0.034)and disease control(HR=0.31,P<0.01)were independently associated with improved OS.RDI≥70%was not statistically significant in multivariate analysis.Conclusions:Our study revealed the importance of achieving RDI≥70%in the first 30 days of treatment to maximize the effects of LEN。
