Table 5.
Factors associated with overall survival in 94 patients who received conversion therapy for initially unresectable HCC.
| Univariate | Multivariate (Model 1)# | Multivariate (Model 2)# | ||||||||
|---|---|---|---|---|---|---|---|---|---|---|
| HR | 95% CI | P | HR | 95% CI | P | HR | 95%CI | P | ||
| Age, y | > 60 vs ≦ 60 | 1.162 | 0.399 – 3.383 | 0.660 | ||||||
| Sex | Male vs Female | 0.990 | 0.233 – 4.201 | 0.989 | ||||||
| HBsAg-positive | Yes vs No | 3.011 | 0.408 – 22.202 | 0.280 | ||||||
| Tumor size, cm | > 10 vs ≦ 10 | 1.314 | 0.555 – 3.107 | 0.535 | ||||||
| Tumor number | multiple vs single | 1.375 | 0.646 – 2.924 | 0.408 | ||||||
| PVTT | Yes vs No | 2.551 | 1.121 – 5.806 | 0.026 | 3.014 | 1.290 – 7.042 | 0.011 | 4.418 | 1.712 – 11.398 | 0.002 |
| Macrovascular invasion |
Yes vs No | 2.410 | 1.020 – 5.691 | 0.045 | NA | NA | ||||
| Extrahepatic metastasis | Yes vs No | 4.651 | 1.918 – 11.275 | 0.001 | 5.068 | 1.897 – 13.534 | 0.001 | 3.189 | 1.172 – 8.678 | 0.023 |
| BCLC stage | Stage C vs A/B | 3.084 | 1.168 – 8.139 | 0.023 | NA | NA | ||||
| BCLC stage | Stage A vs B/C | 0.571 | 0.172 – 1.899 | 0.361 | ||||||
| AFP, ng/mL | > 400 vs ≦ 400 | 2.024 | 0.890 – 4.601 | 0.092 | 3.002 | 1.190 – 7.575 | 0.020 | 2.468 | 0.957 – 6.367 | 0.062 |
| SIRI | > 1.38 vs ≦ 1.38 | 2.172 | 1.006 – 4.688 | 0.048 | 2.144 | 0.900 – 5.110 | 0.085 | 2.098 | 0.844 – 5.214 | 0.111 |
| NLR | > 2.82 vs ≦ 2.82 | 1.688 | 0.796 – 3.580 | 0.172 | ||||||
| PLR | > 146vs ≦ 146 | 1.368 | 0.648 – 2.886 | 0.411 | ||||||
| Platelet count,×109/L | > 100 vs≦ 100 | 2.990 | 0.405 – 22.080 | 0.283 | ||||||
| ALT, U/L | > 40 vs ≦ 40 | 1.123 | 0.531 – 2.378 | 0.761 | ||||||
| AST, U/L | > 40 vs ≦ 40 | 1.015 | 0.382 – 2.698 | 0.977 | ||||||
| Ascites | Yes vs No | 2.232 | 0.831 – 5.998 | 0.111 | ||||||
| Child-Pugh class | Class A vs B | 0.245 | 0.082 – 0.735 | 0.012 | 0.754 | 0.209 –2.711 | 0.665 | 0.880 | 0.255 – 3.036 | 0.840 |
| ALBI grade | Grade1 vs 2/3 | 1.437 | 0.497 – 4.154 | 0.503 | ||||||
| ECOG PS | 0 vs 1 | 0.577 | 0.269 – 1.238 | 0.158 | 0.707 | 0.300 – 1.669 | 0.429 | 0.680 | 0.281 – 1.645 | 0.392 |
| Early AFP response * | Yes vs No | 0.445 | 0.180– 1.102 | 0.080 | – | – | – | 0.580 | 0.210 – 1.600 | 0.293 |
| Early tumor response† | Yes vs No | 0.348 | 0.163 – 0.743 | 0.006 | 0.404 | 0.171 – 0.954 | 0.039 | – | – | – |
| Successful conversion surgery | Yes vs No | 0.135 | 0.044 –0.409 | <0.001 | – | – | – | 0.147 | 0.039 – 0.554 | 0.005 |
AFP, alpha fetoprotein; HCC, hepatocellular carcinoma; ECOG PS, Eastern Cooperative Oncology Group performance status; ALBI grade, albumin-bilirubin grade; ALT, alanine aminotransferase; NA, not adopted; AST, aspartate aminotransferase; BCLC stage, Barcelona-Clinic liver cancer stage; PLR, platelet to lymphocyte ratio; NLR, neutrophil to lymphocyte ratio; SIRI, systemic inflammation response index; CI, confidence interval; OR, odds ratio; PVTT, portal vein tumor thrombosis.
* Early AFP response: AFP reduced > 75% from baseline serum level at first follow-up.
† Early tumor response: Achievement of complete response (CR) and partial response (PR) using mRECIST at first follow-up.
Model 1 did not include successful conversion surgery, early AFP response, macrovascular invasion, and BCLC stage into multivariate analysis to avoid collinearity.
Model 2 did not include early tumor response, macrovascular invasion, and BCLC stage into multivariate analysis to avoid collinearity.
The bold values denote statistically significant results of the multivariate analysis.