Elevated soluble urokinase plasminogen activator receptor serum levels indicate poor survival following transarterial chemoembolization therapy for hepatic malignancies: An exploratory analysis
Sven H Loosen,
Max Schulze‐Hagen,
Mihael Vucur,
Joao Gorgulho,
Pia Paffenholz,
Fabian Benz,
Raphael Mohr,
Münevver Demir,
Alexander Wree,
Christiane Kuhl,
Christian Trautwein,
Frank Tacke,
Philipp Bruners,
Tom Luedde,
Christoph Roderburg
Affiliations
Sven H Loosen
Clinic for Gastroenterology, Hepatology and Infectious Diseases, University Hospital Düsseldorf Medical Faculty of Heinrich Heine University Düsseldorf Düsseldorf Germany
Max Schulze‐Hagen
Department of Diagnostic and Interventional Radiology University Hospital RWTH Aachen Aachen Germany
Mihael Vucur
Clinic for Gastroenterology, Hepatology and Infectious Diseases, University Hospital Düsseldorf Medical Faculty of Heinrich Heine University Düsseldorf Düsseldorf Germany
Joao Gorgulho
Department of Medicine III University Hospital RWTH Aachen Aachen Germany
Pia Paffenholz
Department of Urology University Hospital Cologne Cologne Germany
Fabian Benz
Department of Hepatology and Gastroenterology Charité University Medicine Berlin Berlin Germany
Raphael Mohr
Department of Hepatology and Gastroenterology Charité University Medicine Berlin Berlin Germany
Münevver Demir
Department of Hepatology and Gastroenterology Charité University Medicine Berlin Berlin Germany
Alexander Wree
Department of Hepatology and Gastroenterology Charité University Medicine Berlin Berlin Germany
Christiane Kuhl
Department of Diagnostic and Interventional Radiology University Hospital RWTH Aachen Aachen Germany
Christian Trautwein
Department of Medicine III University Hospital RWTH Aachen Aachen Germany
Frank Tacke
Department of Hepatology and Gastroenterology Charité University Medicine Berlin Berlin Germany
Philipp Bruners
Department of Diagnostic and Interventional Radiology University Hospital RWTH Aachen Aachen Germany
Tom Luedde
Clinic for Gastroenterology, Hepatology and Infectious Diseases, University Hospital Düsseldorf Medical Faculty of Heinrich Heine University Düsseldorf Düsseldorf Germany
Christoph Roderburg
Department of Hepatology and Gastroenterology Charité University Medicine Berlin Berlin Germany
Abstract Background and Aim Transarterial chemoembolization (TACE) represents a standard of care for patients with intermediate‐stage hepatocellular carcinoma (HCC) or liver metastases. However, identification of the ideal candidates for TACE therapy remains challenging. The soluble urokinase plasminogen activator receptor (suPAR) has recently evolved as a prognostic marker in patients with cancer; however no data on suPAR in the context of TACE exists. Methods Serum levels of suPAR were measured by an enzyme‐linked immunosorbent assay in n = 48 TACE patients (HCC: n = 38, liver metastases: n = 10) before intervention and 1 day after TACE, as well as in 20 healthy controls. Results Serum levels of suPAR were significantly elevated in patients with liver cancer compared to healthy controls. Patients with or without an objective tumor response to TACE therapy had comparable levels of circulating suPAR. Importantly, baseline suPARs above the ideal prognostic cut‐off value (5.39 ng/mL) were a significant prognostic marker for reduced overall survival (OS) following TACE. As such, patients with initial suPAR levels >5.39 ng/mL showed a significantly reduced median OS of only 256 days compared to patients with suPAR serum levels below the cut‐off value (median OS: 611 days). In line with previous data, suPAR serum concentrations correlated with those of creatinine but were independent of tumor entity, leukocyte count, and C‐reactive protein in multivariate analysis. Conclusion Baseline suPAR serum levels provide important information on the postinterventional outcome of liver cancer patients receiving TACE.
