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Impact of acute decompensation on the prognosis of patients with hepatocellular carcinoma

BACKGROUND/AIMS: Organ failure in patients with acute decompensation (AD) is a defining characteristic of acute-on-chronic liver failure (ACLF). However, the clinical features of AD during the long-term clinical course of hepatocellular carcinoma (HCC) are still poorly understood. This study aimed t...

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Autores principales: Kondo, Takayuki, Koroki, Keisuke, Kanzaki, Hiroaki, Kobayashi, Kazufumi, Kiyono, Soichiro, Nakamura, Masato, Kanogawa, Naoya, Saito, Tomoko, Ogasawara, Sadahisa, Ooka, Yoshihiko, Nakamoto, Shingo, Chiba, Tetsuhiro, Arai, Makoto, Kato, Jun, Kuboki, Satoshi, Ohtsuka, Masayuki, Kato, Naoya
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8794202/
https://www.ncbi.nlm.nih.gov/pubmed/35085277
http://dx.doi.org/10.1371/journal.pone.0261619
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author Kondo, Takayuki
Koroki, Keisuke
Kanzaki, Hiroaki
Kobayashi, Kazufumi
Kiyono, Soichiro
Nakamura, Masato
Kanogawa, Naoya
Saito, Tomoko
Ogasawara, Sadahisa
Ooka, Yoshihiko
Nakamoto, Shingo
Chiba, Tetsuhiro
Arai, Makoto
Kato, Jun
Kuboki, Satoshi
Ohtsuka, Masayuki
Kato, Naoya
author_facet Kondo, Takayuki
Koroki, Keisuke
Kanzaki, Hiroaki
Kobayashi, Kazufumi
Kiyono, Soichiro
Nakamura, Masato
Kanogawa, Naoya
Saito, Tomoko
Ogasawara, Sadahisa
Ooka, Yoshihiko
Nakamoto, Shingo
Chiba, Tetsuhiro
Arai, Makoto
Kato, Jun
Kuboki, Satoshi
Ohtsuka, Masayuki
Kato, Naoya
author_sort Kondo, Takayuki
collection PubMed
description BACKGROUND/AIMS: Organ failure in patients with acute decompensation (AD) is a defining characteristic of acute-on-chronic liver failure (ACLF). However, the clinical features of AD during the long-term clinical course of hepatocellular carcinoma (HCC) are still poorly understood. This study aimed to clarify features and impact of AD/ACLF on the prognosis of patients after treatment for HCC. METHODS: This retrospective study enrolled 556 consecutive patients who were initially diagnosed with HCC, and analyses were conducted taking into account HCC treatment type, HCC stage, and presence or absence of cirrhosis. RESULTS: During follow-up, 299 patients with AD were hospitalized. AD occurrence is closely related to prognosis, regardless of the presence or absence of cirrhosis and HCC stage, and early-onset AD (within 90 days after HCC treatment) has negative impact on prognosis. In the intermediate-advanced–stage group, surgical resection had a positive impact on AD incidence post-treatment. After systemic therapy for HCC, renal impairment was the predictive factors for AD development. The 28/90-day mortality rate was higher among 41 cases (13.7%) with AD who exhibited ACLF as compared with cases without ACLF. AD without cirrhosis had similar ACLF incidence and short-term mortality, compared to AD with cirrhosis. The prognostic model using a decision-tree–based approach, which includes ACLF, bilirubin level, HCC progression, and MELD score is useful for predicting 90- or 28-day mortality after AD diagnosis. CONCLUSIONS: Careful management of patients with HCC who are hospitalized with AD is necessary, considering ACLF, HCC progression, and liver function.
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spelling pubmed-87942022022-01-28 Impact of acute decompensation on the prognosis of patients with hepatocellular carcinoma Kondo, Takayuki Koroki, Keisuke Kanzaki, Hiroaki Kobayashi, Kazufumi Kiyono, Soichiro Nakamura, Masato Kanogawa, Naoya Saito, Tomoko Ogasawara, Sadahisa Ooka, Yoshihiko Nakamoto, Shingo Chiba, Tetsuhiro Arai, Makoto Kato, Jun Kuboki, Satoshi Ohtsuka, Masayuki Kato, Naoya PLoS One Research Article BACKGROUND/AIMS: Organ failure in patients with acute decompensation (AD) is a defining characteristic of acute-on-chronic liver failure (ACLF). However, the clinical features of AD during the long-term clinical course of hepatocellular carcinoma (HCC) are still poorly understood. This study aimed to clarify features and impact of AD/ACLF on the prognosis of patients after treatment for HCC. METHODS: This retrospective study enrolled 556 consecutive patients who were initially diagnosed with HCC, and analyses were conducted taking into account HCC treatment type, HCC stage, and presence or absence of cirrhosis. RESULTS: During follow-up, 299 patients with AD were hospitalized. AD occurrence is closely related to prognosis, regardless of the presence or absence of cirrhosis and HCC stage, and early-onset AD (within 90 days after HCC treatment) has negative impact on prognosis. In the intermediate-advanced–stage group, surgical resection had a positive impact on AD incidence post-treatment. After systemic therapy for HCC, renal impairment was the predictive factors for AD development. The 28/90-day mortality rate was higher among 41 cases (13.7%) with AD who exhibited ACLF as compared with cases without ACLF. AD without cirrhosis had similar ACLF incidence and short-term mortality, compared to AD with cirrhosis. The prognostic model using a decision-tree–based approach, which includes ACLF, bilirubin level, HCC progression, and MELD score is useful for predicting 90- or 28-day mortality after AD diagnosis. CONCLUSIONS: Careful management of patients with HCC who are hospitalized with AD is necessary, considering ACLF, HCC progression, and liver function. Public Library of Science 2022-01-27 /pmc/articles/PMC8794202/ /pubmed/35085277 http://dx.doi.org/10.1371/journal.pone.0261619 Text en © 2022 Kondo et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Kondo, Takayuki
Koroki, Keisuke
Kanzaki, Hiroaki
Kobayashi, Kazufumi
Kiyono, Soichiro
Nakamura, Masato
Kanogawa, Naoya
Saito, Tomoko
Ogasawara, Sadahisa
Ooka, Yoshihiko
Nakamoto, Shingo
Chiba, Tetsuhiro
Arai, Makoto
Kato, Jun
Kuboki, Satoshi
Ohtsuka, Masayuki
Kato, Naoya
Impact of acute decompensation on the prognosis of patients with hepatocellular carcinoma
title Impact of acute decompensation on the prognosis of patients with hepatocellular carcinoma
title_full Impact of acute decompensation on the prognosis of patients with hepatocellular carcinoma
title_fullStr Impact of acute decompensation on the prognosis of patients with hepatocellular carcinoma
title_full_unstemmed Impact of acute decompensation on the prognosis of patients with hepatocellular carcinoma
title_short Impact of acute decompensation on the prognosis of patients with hepatocellular carcinoma
title_sort impact of acute decompensation on the prognosis of patients with hepatocellular carcinoma
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8794202/
https://www.ncbi.nlm.nih.gov/pubmed/35085277
http://dx.doi.org/10.1371/journal.pone.0261619
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