Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Nov;35(11):1945-1952.
doi: 10.1111/jgh.15008. Epub 2020 Feb 23.

The MAAPE score in intermediate and advanced hepatocellular carcinoma treated with Yttrium-90 resin microsphere radioembolization

Michael C Wallace  1   2   3 , Shaun Samuelson  4 , Tiffany Khoo  2 , Jacob Ooi  2 , Jonathan Tibballs  4 , John Ferguson  4 , David B Preen  3 , Matthew Knuiman  3 , George Garas  1   2 , Gerry MacQuillan  1   2 , Leon A Adams  1   2 , Gary P Jeffrey  1   2
Affiliations

The MAAPE score in intermediate and advanced hepatocellular carcinoma treated with Yttrium-90 resin microsphere radioembolization

Michael C Wallace et al. J Gastroenterol Hepatol. 2020 Nov.

Abstract

Background and aim: Yttrium-90 resin microsphere radioembolization (RE) is not recommended for routine use in intermediate or advanced hepatocellular carcinoma (HCC) by recent guidelines. This study aims to establish pre-treatment variables which predict survival in HCC patients treated with RE to identify those who will benefit most from it, and to inform patient selection for future trials.

Methods: Single center, retrospective study of consecutive patients with HCC treated with RE from 2007 to 2018. Patients included if undergoing their first RE treatment for intermediate or advanced HCC; a Child-Pugh score of B7 or less; and a performance status of 1 or less. Multivariable Cox regression identified variables that were significantly associated with survival. A predictive score was developed based upon coefficients from the fitted Cox regression model, and cubic spline regression was used to identify prognostic groups.

Results: One hundred thirteen patients with intermediate (53.1%) and advanced HCC (45.1%) followed for a median of 13.2 months were included. Variables associated with superior survival used to derive the MAAPE score were lower Model for End-Stage Liver Disease score (≤ 7), lower Alpha-fetoprotein (≤ 150 IU/L), higher serum Albumin (> 37 g/L), absence of Portal vein tumor thrombus, and better performance status (Eastern Cooperative Oncology Group = 0). Three survival prognostic groups were identified: good (median overall survival 25.0 months), average (15.3 months), and poor (6.3 months) (overall log-rank test, P < 0.001).

Conclusion: The MAAPE score accurately identifies HCC patients in whom RE is safe and effective. This will allow for optimal patient selection for future trials of RE versus systemic therapy.

Keywords: Yttrium-90; hepatocellular carcinoma; prediction models; prognosis; resin microsphere radioembolization.

PubMed Disclaimer

References

    1. Bray F, Ferlay J, Soerjomataram I et al. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J. Clin. 2018; 68: 394-424.
    1. de Angelis R, Sant M, Coleman MP et al. Cancer survival in Europe 1999-2007 by country and age: results of EUROCARE-5-a population-based study. Lancet Oncol. 2014; 15: 23-34.
    1. Goutte N, Sogni P, Bendersky N et al. Geographical variations in incidence, management and survival of hepatocellular carcinoma in a Western country. J. Hepatol. 2017; 66: 537-544.
    1. Njei B, Rotman Y, Ditah I et al. Emerging trends in hepatocellular carcinoma incidence and mortality. Hepatology 2015; 61: 191-199.
    1. Wallace MC, Preen DB, Short MW et al. Hepatocellular carcinoma in Australia 1982-2014: increasing incidence and improving survival. Liver Int. 2019; 39: 522-530.

MeSH terms

LinkOut - more resources