Delden, O.M. (Otto M.) van
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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.
- 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.
- Prediction of survival among patients receiving transarterial chemoembolization for hepatocellular carcinoma: A response-based approach(American Association for the Study of Liver Diseases, 2020) Ottaviani, D. (Diego); Jang, J.W. (Jeong W.); Elshaarawy, O. (Omar); Waked, I. (Imam); Berhane, S. (Sarah); García-Fiñana, M. (Marta); Peck-Radosavljevic, M. (Markus); Aithal, G.P. (Guru P.); Han, G. (Guohong); Hucke, F. (Florian); Pinato, D.J. (David J.); Sharma, R. (Rohini); Pirisi, M. (Mario); Kirstein, M. (Martha); Rewisha, E. (Eman); Chan, S.L. (Stephen L.); Meyer, T. (Tim); Sangro, B. (Bruno); Kudo, M. (Masatoshi); Vogel, A. (Arndt); Stern, N. (Nick); Palmer, D. (Daniel); Bettinger, D. (Dominik); Cucchetti, A. (Alessandro); Travis, S. (Simon); Gomaa, A. (Asmaa); Labeur, T.A. (Tim A.); Delden, O.M. (Otto M.) van; Mosconi, C. (Cristina); Takkenberg, R.B. (R. B.); Chan, A.W.H. (Anthony W. H.); Johnson, P.J. (Philip J.); Toyoda, H. (Hidenori); Fateen, W. (Waleed)Background and aims: The heterogeneity of intermediate-stage hepatocellular carcinoma (HCC) and the widespread use of transarterial chemoembolization (TACE) outside recommended guidelines have encouraged the development of scoring systems that predict patient survival. The aim of this study was to build and validate statistical models that offer individualized patient survival prediction using response to TACE as a variable. Approach and results: Clinically relevant baseline parameters were collected for 4,621 patients with HCC treated with TACE at 19 centers in 11 countries. In some of the centers, radiological responses (as assessed by modified Response Evaluation Criteria in Solid Tumors [mRECIST]) were also accrued. The data set was divided into a training set, an internal validation set, and two external validation sets. A pre-TACE model ("Pre-TACE-Predict") and a post-TACE model ("Post-TACE-Predict") that included response were built. The performance of the models in predicting overall survival (OS) was compared with existing ones. The median OS was 19.9 months. The factors influencing survival were tumor number and size, alpha-fetoprotein, albumin, bilirubin, vascular invasion, cause, and response as assessed by mRECIST. The proposed models showed superior predictive accuracy compared with existing models (the hepatoma arterial embolization prognostic score and its various modifications) and allowed for patient stratification into four distinct risk categories whose median OS ranged from 7 months to more than 4 years. Conclusions: A TACE-specific and extensively validated model based on routinely available clinical features and response after first TACE permitted patient-level prognostication