Authors:	Müller, Lukas Gairing, Simon J. Foerster, Friedrich Weinmann, Arndt Mittler, Jens Stoehr, Fabian Graafen, Dirk Düber, Christoph Galle, Peter R. Kloeckner, Roman Hahn, Felix
Title:	Portal hypertension in patients with hepatocellular carcinoma and immunotherapy : prognostic relevance of CT-morphologic estimates
Online publication date:	26-Jan-2024
Year of first publication:	2023
Language:	english
Abstract:	Background Clinically significant portal hypertension (CSPH) has been identified as an important prognostic factor in patients with hepatocellular carcinoma (HCC) undergoing curative treatment. This study aimed to assess PH estimates as prognostic factors in patients with HCC treated with immunotherapy. Methods All patients with HCC treated with an immunotherapeutic agent in first or subsequent lines at our tertiary care center between 2016 and 2021 were included (n = 50). CSPH was diagnosed using the established PH score for non-invasive PH estimation in pre-treatment CT data (cut-off ≥ 4). Influence of PH on overall survival (OS) and progression-free survival (PFS) was assessed in uni- and multivariable analyses. Results Based on the PH score, 26 patients (52.0%) were considered to have CSPH. After treatment initiation, patients with CSPH had a significantly impaired median OS (4.1 vs 33.3 months, p < 0.001) and a significantly impaired median PFS (2.7 vs 5.3 months, p = 0.02). In multivariable Cox regression, CSPH remained significantly associated with survival (HR 2.9, p = 0.015) when adjusted for established risk factors. Conclusions Non-invasive assessment of CSPH using routine CT data yielded an independent prognostic factor in patients with HCC and immunotherapy. Therefore, it might function as an additional imaging biomarker to detect high-risk patients with poor survival and possibly for treatment decision making.
DDC:	610 Medizin 610 Medical sciences
Institution:	Johannes Gutenberg-Universität Mainz
Department:	FB 04 Medizin
Place:	Mainz
ROR:	https://ror.org/023b0x485
DOI:	http://doi.org/10.25358/openscience-9977
Version:	Published version
Publication type:	Zeitschriftenaufsatz
Document type specification:	Scientific article
License:	CC BY
Information on rights of use:	https://creativecommons.org/licenses/by/4.0/
Journal:	Cancer imaging 23
Pages or article number:	40
Publisher:	BioMed Central
Publisher place:	London
Issue date:	2023
ISSN:	1470-7330
Publisher DOI:	10.1186/s40644-023-00558-7
Appears in collections:	DFG-491381577-G