13 C-Methacetin Breath Test Predicts Survival in Patients With Hepatocellular Carcinoma Undergoing Transarterial Chemoembolization.
Journal
Clinical and translational gastroenterology
ISSN: 2155-384X
Titre abrégé: Clin Transl Gastroenterol
Pays: United States
ID NLM: 101532142
Informations de publication
Date de publication:
01 10 2022
01 10 2022
Historique:
received:
08
06
2022
accepted:
16
08
2022
pubmed:
11
9
2022
medline:
3
11
2022
entrez:
10
9
2022
Statut:
epublish
Résumé
The 13 C-methacetin breath test ( 13 C-MBT) is a dynamic method for assessing liver function. This proof-of-concept study aimed to investigate the association between 13 C-MBT values and outcomes in patients with hepatocellular carcinoma (HCC) undergoing transarterial chemoembolization (TACE). A total of 30 patients with HCC were prospectively recruited. Of these, 25 were included in baseline and 20 in longitudinal analysis. 13 C-MBTs were performed before the first and second TACE session. Patients were followed for at least 1 year. At baseline, the median 13 C-MBT value was 261 μg/kg/hr (interquartile range 159-387). 13 C-MBT, albumin-bilirubin, Child-Pugh, and Model for End-Stage Liver Disease scores were associated with overall survival in extended univariable Cox regression ( 13 C-MBT: standardized hazard ratio [sHR] 0.297, 95% confidence interval [CI] 0.111-0.796; albumin-bilirubin score: sHR 4.051, 95% CI 1.813-9.052; Child-Pugh score: sHR 2.616, 95% CI 1.450-4.719; Model for End-Stage Liver Disease score: sHR 2.781, 95% CI 1.356-5.703). Using a cutoff of 140 μg/kg/hr at baseline, 13 C-MBT was associated with prognosis (median overall survival 28.5 months [95% CI 0.0-57.1] vs 3.5 months [95% CI 0.0-8.1], log-rank P < 0.001). Regarding prediction of 90-day mortality after second 13 C-MBT, the relative change in 13 C-MBT values yielded an area under the receiver-operating characteristic curve of 1.000 ( P = 0.007). Baseline and longitudinal 13 C-MBT values predict survival of patients with HCC undergoing TACE. The relative change in 13 C-MBT values predicts short-term mortality and may assist in identifying patients who will not benefit from further TACE treatment.
Identifiants
pubmed: 36087052
doi: 10.14309/ctg.0000000000000529
pii: 01720094-202210000-00009
pmc: PMC9624494
doi:
Substances chimiques
methacetin
13E468TFHP
Bilirubin
RFM9X3LJ49
Albumins
0
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
e00529Informations de copyright
Copyright © 2022 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of The American College of Gastroenterology.
Références
Sung H, Ferlay J, Siegel RL, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 2021;71(3):209–49.
Foerster F, Gairing SJ, Müller L, et al. NAFLD-driven HCC: Safety and efficacy of current and emerging treatment options. J Hepatol 2022;76(2):446–57.
European Association for the Study of the Liver. EASL clinical practice guidelines: Management of hepatocellular carcinoma. J Hepatol 2018;69(1):182–236.
Miksad RA, Ogasawara S, Xia F, et al. Liver function changes after transarterial chemoembolization in US hepatocellular carcinoma patients: The LiverT study. BMC Cancer 2019;19(1):795.
Foerster F, Gairing SJ, Ilyas SI, et al. Emerging immunotherapy for hepatocellular carcinoma: A guide for hepatologists. Hepatology 2022;75(6):1604–26.
Finn RS, Qin S, Ikeda M, et al. IMbrave150: Updated overall survival (OS) data from a global, randomized, open-label phase III study of atezolizumab (atezo) + bevacizumab (bev) versus sorafenib (sor) in patients (pts) with unresectable hepatocellular carcinoma (HCC). J Clin Oncol 2021;39(3 Suppl):267.
Reig M, Forner A, Rimola J, et al. BCLC strategy for prognosis prediction and treatment recommendation Barcelona Clinic Liver Cancer (BCLC) staging system. The 2022 update. J Hepatol 2022;76(3):681–93.
Memon K, Kulik L, Lewandowski RJ, et al. Prospective evaluation of patients with early-/intermediate-stage hepatocellular carcinoma with disease progression following arterial locoregional therapy: Candidacy for systemic treatment or clinical trials. J Vasc Interv Radiol 2013;24(8):1189–97.e2.
Müller L, Hahn F, Mähringer-Kunz A, et al. Immunonutritive scoring in patients with hepatocellular carcinoma undergoing transarterial chemoembolization: Prognostic nutritional index or controlling nutritional status score? Front Oncol 2021;11:696183.
Stockmann M, Lock JF, Riecke B, et al. Prediction of postoperative outcome after hepatectomy with a new bedside test for maximal liver function capacity. Ann Surg 2009;250(1):119–25.
Kaffarnik M, Stoeger G, Liebich J, et al. Liver function, quantified by LiMAx test, after major abdominal surgery. Comparison between open and laparoscopic approach. World J Surg 2018;42(2):557–66.
Rashidi-Alavijeh J, Kahraman A, Gerken G, et al. Enzymatic liver function measured by LiMAx is superior to current standard methods in predicting transplant-free survival after TIPS implantation. Sci Rep 2021;11(1):13834.
Fontana RJ, Stravitz RT, Durkalski V, et al. Prognostic value of the 13 C-methacetin breath test in adults with acute liver failure and non-acetaminophen acute liver injury. Hepatology 2021;74(2):961–72.
Nee J, Schroeder T, Vornholt F, et al. Dynamic determination of functional liver capacity with the LiMAx test in post-cardiac arrest patients undergoing targeted temperature management—A prospective trial. Acta Anaesthesiol Scand 2020;64(4):501–7.
Lock JF, Westphal T, Rubin T, et al. LiMAx test improves diagnosis of chemotherapy-associated liver injury before resection of colorectal liver metastases. Ann Surg Oncol 2017;24(9):2447–55.
Kreimeyer H, Buechter M, Best J, et al. Performance of the LiMAx test, fibrinogen, and transient elastography in patients with acute liver injury. Dig Dis 2022. doi: 10.1159/000523696 .
von Elm E, Altman DG, Egger M, et al. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: Guidelines for reporting observational studies. Lancet 2007;370(9596):1453–7.
Stockmann M, Lock JF, Malinowski M, et al. The LiMAx test: A new liver function test for predicting postoperative outcome in liver surgery. HPB (Oxford) 2010;12(2):139–46.
Lencioni R, de Baere T, Burrel M, et al. Transcatheter treatment of hepatocellular carcinoma with doxorubicin-loaded DC Bead (DEBDOX): Technical recommendations. Cardiovasc Intervent Radiol 2012;35(5):980–5.
de Baere T, Arai Y, Lencioni R, et al. Treatment of liver tumors with lipiodol TACE: Technical recommendations from experts opinion. Cardiovasc Intervent Radiol 2016;39(3):334–43.
Barzakova ES, Schulze-Hagen M, Zimmermann M, et al. Monitoring liver function of patients undergoing transarterial chemoembolization (TACE) by a 13C breath test (LiMAx). Cardiovasc Intervent Radiol 2019;42(12):1702–8.
Reichert MC, Massmann A, Schulz A, et al. Volume-function analysis (LiMAx test) in patients with HCC and cirrhosis undergoing TACE-A feasibility study. Dig Dis Sci 2021;66(7):2452–60.
Senk K, Wilcke J, Haimerl M, et al. Prediction of Transarterial Chemoembolization (TACE)—Outcome by pre- and postinterventional 13C-methacetin breath test. Clin Hemorheol Microcirc 2021;79:73–80.
Le Daré B, Lagente V, Gicquel T. Ethanol and its metabolites: Update on toxicity, benefits, and focus on immunomodulatory effects. Drug Metab Rev 2019;51(4):545–61.
Zhu Q, Huang C, Meng X, et al. CYP1A2 contributes to alcohol-induced abnormal lipid metabolism through the PTEN/AKT/SREBP-1c pathway. Biochem Biophys Res Commun 2019;513(2):509–14.