Bargellini, I. (Irene)

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    Impact of body composition in advanced hepatocellular carcinoma: a subanalysis of the SORAMIC trial
    (2023) Thormann, M. (Maximilian); Gebauer, B. (Bernhard); Loewe, C. (Christian); Wienke, A. (Andreas); Surov, A. (Alexey); Iezzi, R. (Roberto); Zech, C.J. (Christoph J.); Gasbarrini, A. (Antonio); Schütte, K. (Kerstin); Klümpen, H. (Heinz); Verslype, C. (Chris); Öcal, O. (Osman); Bargellini, I. (Irene); Sangro, B. (Bruno); Seidensticker, R. (Ricarda); Sengel, C. (Christian); Seidensticker, M. (Max); Omari, J. (Jazan); Berg, T. (Thomas); Pech, M. (Maciej); Amthauer, H. (Holger); Delden, O.M. (Otto M.) van; Vandecaveye, V. (Vincent); Ricke, J. (Jeans); Benckert, J. (Julia); Malfertheiner, P. (Peter); Hinnerichs, M. (Mattes)
    Background:Body composition parameters have been reported to be prognostic factors in patients with oncologic diseases. However, the available data on patients with HCC are conflicting. The aim of this study was to assess the impact of body composition on survival in patients with HCC treated with sorafenib or selective internal radioembolization (SIRT) and sorafenib. Methods:This is an exploratory subanalysis of the prospective, randomized controlled SORAMIC trial. Within the palliative arm of the study, patients were selected if a baseline abdominal CT was available. A broad set of skeletal muscle and adipose tissue parameters were measured at the L3 level. Low skeletal muscle mass (LSMM) and density parameters were defined using published cutoffs. The parameters were correlated with overall survival. Results:Of 424 patients in the palliative study arm, 369 patients were included in the analysis. There were 192 patients in the combined sorafenib/SIRT and 177 patients in the sorafenib group. Median overall survival was 9.9 months for the entire cohort and 10.8 and 9.2 months for the SIRT/sorafenib and sorafenib groups, respectively. There was no relevant association of either body composition parameter with overall survival in either the overall cohort or in the SIRT/sorafenib or sorafenib subgroups. Conclusions:This subanalysis of the prospective SORAMIC trial does not suggest a relevant influence of body composition parameters of survival in patients with advanced HCC. Body composition parameters therefore do not serve in patient allocation in this palliative treatment cohort.
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    Prognostic role of radiomics-based body composition analysis for the 1-year survival for hepatocellular carcinoma patients
    (2023) Gebauer, B. (Bernhard); Hille, G. (Georg); Loewe, C. (Christian); Surov, A. (Alexey); Iezzi, R. (Roberto); Zech, C.J. (Christoph J.); Kreherm, R. (Rober); Gasbarrini, A. (Antonio); Klümpen, H. (Heinz); Verslype, C. (Chris); Saalfeld, S. (Sylvia); Öcal, O. (Osman); Bargellini, I. (Irene); Sangro, B. (Bruno); Sengel, C. (Christian); Seidensticker, M. (Max); Schuette, K. (Kerstin); Berg, T. (Thomas); Pech, M. (Maciej); Amthauer, H. (Holger); Delden, O.M. (Otto M.) van; Niemann, U. (Uli); Preim, B. (Bernhard); Vandecaveye, V. (Vincent); Ricke, J. (Jeans); Benckert, J. (Julia); Malfertheiner, P. (Peter); Hinnerichs, M. (Mattes)
    BackgroundParameters of body composition have prognostic potential in patients with oncologic diseases. The aim of the present study was to analyse the prognostic potential of radiomics-based parameters of the skeletal musculature and adipose tissues in patients with advanced hepatocellular carcinoma (HCC). MethodsRadiomics features were extracted from a cohort of 297 HCC patients as post hoc sub-study of the SORAMIC randomized controlled trial. Patients were treated with selective internal radiation therapy (SIRT) in combination with sorafenib or with sorafenib alone yielding two groups: (1) sorafenib monotherapy (n = 147) and (2) sorafenib and SIRT (n = 150). The main outcome was 1-year survival. Segmentation of muscle tissue and adipose tissue was used to retrieve 881 features. Correlation analysis and feature cleansing yielded 292 features for each patient group and each tissue type. We combined 9 feature selection methods with 10 feature set compositions to build 90 feature sets. We used 11 classifiers to build 990 models. We subdivided the patient groups into a train and validation cohort and a test cohort, that is, one third of the patient groups. ResultsWe used the train and validation set to identify the best feature selection and classification model and applied it to the test set for each patient group. Classification yields for patients who underwent sorafenib monotherapy an accuracy of 75.51% and area under the curve (AUC) of 0.7576 (95% confidence interval [CI]: 0.6376-0.8776). For patients who underwent treatment with SIRT and sorafenib, results are accuracy = 78.00% and AUC = 0.8032 (95% CI: 0.6930-0.9134). ConclusionsParameters of radiomics-based analysis of the skeletal musculature and adipose tissue predict 1-year survival in patients with advanced HCC. The prognostic value of radiomics-based parameters was higher in patients who were treated with SIRT and sorafenib.
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    Predictive factors for adverse event outcomes after transarterial radioembolization with Yttrium-90 resin microspheres in Europe: results from the prospective observational CIRT study
    (2023) Albrecht, T. (Thomas); Peynircioglu, B. (Bora); Munneke, G. (Graham); Arnold, D. (Dirk); Pereira, H. (Helena); Bargellini, I. (Irene); Sangro, B. (Bruno); Kolligs, F. (Frank); Bilbao, J.I. (José I.); Maleux, G. (Geert); Cianni, R. (Roberto); Jong, N. (Niels) de; Helmberger, T. (Thomas); Zeka, B. (Bleranda); Schaefer, N. (Niklaus)
    BackgroundUsing data collected in the prospective observational study CIRSE Registry for SIR-Spheres Therapy, the present study aimed at identifying predictors of adverse events (AEs) following transarterial radioembolization (TARE) with Yttrium-90 resin microspheres for liver tumours.MethodsWe analysed 1027 patients enrolled between January 2015 and December 2017 and followed up for 24 months. Four hundred and twenty-two patients with hepatocellular carcinoma (HCC), 120 with intrahepatic carcinoma (ICC), 237 with colorectal liver metastases and 248 with liver metastases from other primaries were included. Prognostic factors were calculated with a univariable analysis by using the overall AEs burden score (AEBS).ResultsAll-cause AEs were reported in 401/1027 (39.1%) patients, with AEs associated with TARE, such as abdominal pain (16.6%), fatigue (17%), and nausea (11.7%) reported most frequently. Grade 3 or higher AEs were reported in 92/1027 (9%) patients. Reports on grade >= 3 gastrointestinal ulcerations (0.4%), gastritis (0.3%), radiation cholecystitis (0.2%) or radioembolization-induced liver disease (0.5%) were uncommon. Univariable analysis showed that in HCC, AEBS increased for Eastern Cooperative Oncology Group (ECOG) 0 (p = 0.0045), 1 tumour nodule (0.0081), > 1 TARE treatment (p = 0.0224), no prophylactic embolization (p = 0.0211), partition model dosimetry (p = 0.0007) and unilobar treatment target (0.0032). For ICC, > 1 TARE treatment was associated with an increase in AEBS (p = 0.0224), and for colorectal liver metastases, ECOG 0 (p = 0.0188), > 2 prior systemic treatments (p = 0.0127), and 1 tumour nodule (p = 0.0155) were associated with an increased AEBS.ConclusionOur study confirms that TARE is a safe treatment with low toxicity and a minimal impact on quality of life.