Remission, relapse, and metastasis/death of small hepatocellular carcinoma treated with percutaneous ethanol injection

Chao Sheng Liao, Kuo Ching Yang, Amy Ming Fang Yen, Li Sheng Chen, Tony Hsiu Hsi Chen

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

PURPOSE: This study aimed to quantify the full clinical courses characterized by alternating transitions between remission and relapses for small hepatocellular carcinomas treated by percutaneous ethanol injection, and to ascertain the significant predictors for the remission, relapse, and finally to metastasis or death. PATIENTS AND METHODS: A three-state Markov process was used to depict full clinical course. A total of 108 patients who underwent nonsurgical therapy as the first choice of treatment were derived from consecutive clinical series of patients registered in one medical center renowned for their use of percutaneous ethanol injection. RESULTS: We found that approximately 57.19% (95% confidence interval [CI]: 39.82%, 74.56%) patients were promptly responsive to initial treatment, whereas 43.81% had delayed response or were resistant to treatment. The rate of relapse (per month) was higher than the rate of remission (19.20% [95% CI: 15.36%, 23.04%] vs. 13.82% [95% CI: 10.72%, 16.93%]). The results from the multivariate analysis indicate that the significant predictors for the full clinical courses are total bilirubin, α-fetoprotein, prothrombin time, globulin, tumor morphology, and alkaline phosphatase. CONCLUSIONS: A three-state remission-relapse-death model was proposed to quantify and ascertain the predictors for the multistate disease progression of small hepatocellular carcinomas treated by percutaneous ethanol injection. This model captures the risk of recurrence of tumor as well as the primary endpoint of death.

Original languageEnglish
Pages (from-to)194-200
Number of pages7
JournalCancer Journal
Volume12
Issue number3
DOIs
Publication statusPublished - 2006
Externally publishedYes

Fingerprint

Hepatocellular Carcinoma
Ethanol
Neoplasm Metastasis
Recurrence
Injections
Confidence Intervals
Fetal Proteins
Markov Chains
Prothrombin Time
Therapeutics
Bilirubin
Alkaline Phosphatase
Disease Progression
Multivariate Analysis
Neoplasms

Keywords

  • Clinical course
  • Hepatocellular carcinoma
  • Markov process
  • Percutaneous ethanol injection

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Remission, relapse, and metastasis/death of small hepatocellular carcinoma treated with percutaneous ethanol injection. / Liao, Chao Sheng; Yang, Kuo Ching; Yen, Amy Ming Fang; Chen, Li Sheng; Chen, Tony Hsiu Hsi.

In: Cancer Journal, Vol. 12, No. 3, 2006, p. 194-200.

Research output: Contribution to journalArticle

@article{3600e94c870e43d8b325c30b9fa070d6,
title = "Remission, relapse, and metastasis/death of small hepatocellular carcinoma treated with percutaneous ethanol injection",
abstract = "PURPOSE: This study aimed to quantify the full clinical courses characterized by alternating transitions between remission and relapses for small hepatocellular carcinomas treated by percutaneous ethanol injection, and to ascertain the significant predictors for the remission, relapse, and finally to metastasis or death. PATIENTS AND METHODS: A three-state Markov process was used to depict full clinical course. A total of 108 patients who underwent nonsurgical therapy as the first choice of treatment were derived from consecutive clinical series of patients registered in one medical center renowned for their use of percutaneous ethanol injection. RESULTS: We found that approximately 57.19{\%} (95{\%} confidence interval [CI]: 39.82{\%}, 74.56{\%}) patients were promptly responsive to initial treatment, whereas 43.81{\%} had delayed response or were resistant to treatment. The rate of relapse (per month) was higher than the rate of remission (19.20{\%} [95{\%} CI: 15.36{\%}, 23.04{\%}] vs. 13.82{\%} [95{\%} CI: 10.72{\%}, 16.93{\%}]). The results from the multivariate analysis indicate that the significant predictors for the full clinical courses are total bilirubin, α-fetoprotein, prothrombin time, globulin, tumor morphology, and alkaline phosphatase. CONCLUSIONS: A three-state remission-relapse-death model was proposed to quantify and ascertain the predictors for the multistate disease progression of small hepatocellular carcinomas treated by percutaneous ethanol injection. This model captures the risk of recurrence of tumor as well as the primary endpoint of death.",
keywords = "Clinical course, Hepatocellular carcinoma, Markov process, Percutaneous ethanol injection",
author = "Liao, {Chao Sheng} and Yang, {Kuo Ching} and Yen, {Amy Ming Fang} and Chen, {Li Sheng} and Chen, {Tony Hsiu Hsi}",
year = "2006",
doi = "10.1097/00130404-200605000-00007",
language = "English",
volume = "12",
pages = "194--200",
journal = "Cancer journal (Sudbury, Mass.)",
issn = "1528-9117",
publisher = "Lippincott Williams and Wilkins",
number = "3",

}

TY - JOUR

T1 - Remission, relapse, and metastasis/death of small hepatocellular carcinoma treated with percutaneous ethanol injection

AU - Liao, Chao Sheng

AU - Yang, Kuo Ching

AU - Yen, Amy Ming Fang

AU - Chen, Li Sheng

AU - Chen, Tony Hsiu Hsi

PY - 2006

Y1 - 2006

N2 - PURPOSE: This study aimed to quantify the full clinical courses characterized by alternating transitions between remission and relapses for small hepatocellular carcinomas treated by percutaneous ethanol injection, and to ascertain the significant predictors for the remission, relapse, and finally to metastasis or death. PATIENTS AND METHODS: A three-state Markov process was used to depict full clinical course. A total of 108 patients who underwent nonsurgical therapy as the first choice of treatment were derived from consecutive clinical series of patients registered in one medical center renowned for their use of percutaneous ethanol injection. RESULTS: We found that approximately 57.19% (95% confidence interval [CI]: 39.82%, 74.56%) patients were promptly responsive to initial treatment, whereas 43.81% had delayed response or were resistant to treatment. The rate of relapse (per month) was higher than the rate of remission (19.20% [95% CI: 15.36%, 23.04%] vs. 13.82% [95% CI: 10.72%, 16.93%]). The results from the multivariate analysis indicate that the significant predictors for the full clinical courses are total bilirubin, α-fetoprotein, prothrombin time, globulin, tumor morphology, and alkaline phosphatase. CONCLUSIONS: A three-state remission-relapse-death model was proposed to quantify and ascertain the predictors for the multistate disease progression of small hepatocellular carcinomas treated by percutaneous ethanol injection. This model captures the risk of recurrence of tumor as well as the primary endpoint of death.

AB - PURPOSE: This study aimed to quantify the full clinical courses characterized by alternating transitions between remission and relapses for small hepatocellular carcinomas treated by percutaneous ethanol injection, and to ascertain the significant predictors for the remission, relapse, and finally to metastasis or death. PATIENTS AND METHODS: A three-state Markov process was used to depict full clinical course. A total of 108 patients who underwent nonsurgical therapy as the first choice of treatment were derived from consecutive clinical series of patients registered in one medical center renowned for their use of percutaneous ethanol injection. RESULTS: We found that approximately 57.19% (95% confidence interval [CI]: 39.82%, 74.56%) patients were promptly responsive to initial treatment, whereas 43.81% had delayed response or were resistant to treatment. The rate of relapse (per month) was higher than the rate of remission (19.20% [95% CI: 15.36%, 23.04%] vs. 13.82% [95% CI: 10.72%, 16.93%]). The results from the multivariate analysis indicate that the significant predictors for the full clinical courses are total bilirubin, α-fetoprotein, prothrombin time, globulin, tumor morphology, and alkaline phosphatase. CONCLUSIONS: A three-state remission-relapse-death model was proposed to quantify and ascertain the predictors for the multistate disease progression of small hepatocellular carcinomas treated by percutaneous ethanol injection. This model captures the risk of recurrence of tumor as well as the primary endpoint of death.

KW - Clinical course

KW - Hepatocellular carcinoma

KW - Markov process

KW - Percutaneous ethanol injection

UR - http://www.scopus.com/inward/record.url?scp=33745142614&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=33745142614&partnerID=8YFLogxK

U2 - 10.1097/00130404-200605000-00007

DO - 10.1097/00130404-200605000-00007

M3 - Article

VL - 12

SP - 194

EP - 200

JO - Cancer journal (Sudbury, Mass.)

JF - Cancer journal (Sudbury, Mass.)

SN - 1528-9117

IS - 3

ER -