Scientific Reports (May 2022)
C-reactive protein to albumin ratio predicts survival in patients with unresectable hepatocellular carcinoma treated with lenvatinib
- Toshifumi Tada,
- Takashi Kumada,
- Atsushi Hiraoka,
- Masashi Hirooka,
- Kazuya Kariyama,
- Joji Tani,
- Masanori Atsukawa,
- Koichi Takaguchi,
- Ei Itobayashi,
- Shinya Fukunishi,
- Kunihiko Tsuji,
- Toru Ishikawa,
- Kazuto Tajiri,
- Hironori Ochi,
- Satoshi Yasuda,
- Hidenori Toyoda,
- Takeshi Hatanaka,
- Satoru Kakizaki,
- Noritomo Shimada,
- Kazuhito Kawata,
- Takaaki Tanaka,
- Hideko Ohama,
- Kazuhiro Nouso,
- Asahiro Morishita,
- Akemi Tsutsui,
- Takuya Nagano,
- Norio Itokawa,
- Tomomi Okubo,
- Taeang Arai,
- Michitaka Imai,
- Atsushi Naganuma,
- Tomoko Aoki,
- Yohei Koizumi,
- Shinichiro Nakamura,
- Kouji Joko,
- Yoichi Hiasa,
- Masatoshi Kudo
Affiliations
- Toshifumi Tada
- Department of Internal Medicine, Japanese Red Cross Himeji Hospital
- Takashi Kumada
- Department of Nursing, Gifu Kyoritsu University
- Atsushi Hiraoka
- Gastroenterology Center, Ehime Prefectural Central Hospital
- Masashi Hirooka
- Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine
- Kazuya Kariyama
- Department of Gastroenterology, Okayama City Hospital
- Joji Tani
- Department of Gastroenterology and Hepatology, Kagawa University
- Masanori Atsukawa
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Nippon Medical School
- Koichi Takaguchi
- Department of Hepatology, Kagawa Prefectural Central Hospital
- Ei Itobayashi
- Department of Gastroenterology, Asahi General Hospital
- Shinya Fukunishi
- Department of Gastroenterology, Osaka Medical College
- Kunihiko Tsuji
- Center of Gastroenterology, Teine Keijinkai Hospital
- Toru Ishikawa
- Department of Gastroenterology, Saiseikai Niigata Hospital
- Kazuto Tajiri
- Department of Gastroenterology, Toyama University Hospital
- Hironori Ochi
- Hepato-Biliary Center, Japanese Red Cross Matsuyama Hospital
- Satoshi Yasuda
- Department of Gastroenterology and Hepatology, Ogaki Municipal Hospital
- Hidenori Toyoda
- Department of Gastroenterology and Hepatology, Ogaki Municipal Hospital
- Takeshi Hatanaka
- Department of Gastroenterology, Gunma Saiseikai Maebashi Hospital
- Satoru Kakizaki
- Department of Clinical Research, National Hospital Organization Takasaki General Medical Center
- Noritomo Shimada
- Division of Gastroenterology and Hepatology, Otakanomori Hospital
- Kazuhito Kawata
- Department of Hepatology, Hamamatsu University School of Medicine
- Takaaki Tanaka
- Gastroenterology Center, Ehime Prefectural Central Hospital
- Hideko Ohama
- Department of Gastroenterology, Osaka Medical College
- Kazuhiro Nouso
- Department of Gastroenterology, Okayama City Hospital
- Asahiro Morishita
- Department of Gastroenterology and Hepatology, Kagawa University
- Akemi Tsutsui
- Department of Hepatology, Kagawa Prefectural Central Hospital
- Takuya Nagano
- Department of Hepatology, Kagawa Prefectural Central Hospital
- Norio Itokawa
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Nippon Medical School
- Tomomi Okubo
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Nippon Medical School
- Taeang Arai
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Nippon Medical School
- Michitaka Imai
- Department of Gastroenterology, Saiseikai Niigata Hospital
- Atsushi Naganuma
- Department of Gastroenterology, National Hospital Organization Takasaki General Medical Center
- Tomoko Aoki
- Department of Gastroenterology and Hepatology, Kindai University
- Yohei Koizumi
- Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine
- Shinichiro Nakamura
- Department of Internal Medicine, Japanese Red Cross Himeji Hospital
- Kouji Joko
- Hepato-Biliary Center, Japanese Red Cross Matsuyama Hospital
- Yoichi Hiasa
- Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine
- Masatoshi Kudo
- Department of Gastroenterology and Hepatology, Kindai University
- DOI
- https://doi.org/10.1038/s41598-022-12058-y
- Journal volume & issue
-
Vol. 12,
no. 1
pp. 1 – 10
Abstract
Abstract We investigated the impact of C-reactive protein to albumin ratio (CAR) on predicting outcomes in 522 patients with unresectable hepatocellular carcinoma (HCC) treated with lenvatinib. We determined the optimal CAR cutoff value with time-dependent receiver operating characteristic curve analysis. Additionally, we clarified the relationship between CAR and liver function or HCC progression. Median overall survival was 20.0 (95% confidence interval (CI), 17.2–22.6) months. The optimal CAR cutoff value was determined to be 0.108. Multivariate analysis showed that high CAR (≥ 0.108) (hazard ratio (HR), 1.915; 95% CI, 1.495–2.452), Eastern Cooperative Oncology Group performance status ≥ 1 (HR, 1.429), and α-fetoprotein ≥ 400 ng/mL (HR, 1.604) were independently associated with overall survival. Cumulative overall survival differed significantly between patients with low versus high CAR (p < 0.001). Median progression-free survival was 7.5 (95% CI, 6.7–8.1) months. Multivariate analysis showed that age, CAR ≥ 0.108 (HR, 1.644; 95% CI, 1.324–2.043), and non-hepatitis B, non-hepatitis C etiology (HR, 0.726) were independently associated with progression-free survival. Cumulative progression-free survival differed significantly between patients with low versus high CAR (p < 0.001). CAR values were significantly higher as Japan Integrated Staging score increased (p < 0.001). In conclusion, CAR can predict outcomes in patients with unresectable HCC treated with lenvatinib.
