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- 저자 : ( Mohamad Mady ) (검색결과 1 건)
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( Yeonjung Ha ),( Mohamed A. Mohamed Ali ),( Molly M. Petersen ),( William S. Harmsen ),( Terry M. Therneau ),( Han Chu Lee ),( Baek-yeol Ryoo ),( Sally Bampoh ),( Kenneth A. Valles ),( Mohamad Mady ) 대한간학회 2020 춘·추계 학술대회 (KASL) Vol.2020 No.1
Aims: The ability of the pretreatment lymphocyte to monocyte ratio (LMR) to predict outcomes of patients with hepatocellular carcinoma (HCC) receiving sorafenib is not conclusively determined. Methods: We retrospectively studied patients treated with sorafenib for HCC in two tertiary referral centres in Asia and North America. Primary endpoints were overall survival (OS) and progression-free survival (PFS). Predictive factors for the outcomes were determined by Cox proportional hazards models. A risk-assessment tool was developed. Results: Compared to the North America cohort, the Asia cohort was more heavily pretreated (72.1% vs. 35.2%; P<0.001), had higher hepatitis B virus infection (87.6% vs. 5.6%; P<0.001), and more distant metastases (83.2% vs. 25.4%; P<0.001). Lower monocyte count in the Asia cohort (median, 462.7 vs. 600.0/μL; P=0.023) resulted in a higher LMR (median, 2.6 vs. 1.8; P<0.001). High LMR was associated with a significantly higher OS (hazard ratio [HR], 0.88; 95% confidence interval [CI], 0.81-0.97; P=0.007). This was confirmed in a sensitivity analysis including patients treated in Asia only (HR, 0.89; 95% CI, 0.81-0.97; P=0.010). An OS nomogram was constructed with following variables selected in the multivariate Cox model: LMR, treatment location, previous treatment, performance status, AFP, lymph node metastasis, and Child-Pugh score. The concordance score was 0.71 (95% CI, 0.69-0.73). LMR did not predict PFS. Conclusions: Pretreatment LMR predicts OS in HCC patients treated with sorafenib. Our OS nomogram, incorporating LMR, can be offered to clinicians to improve their ability to assess prognosis, strengthen the prognosis-based decision making, and inform patients in the clinic.
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