Article ; Online: 13 C-Methacetin Breath Test Predicts Survival in Patients With Hepatocellular Carcinoma Undergoing Transarterial Chemoembolization.
Clinical and translational gastroenterology
2022 Volume 13, Issue 10, Page(s) e00529
Abstract: Introduction: The 13 C-methacetin breath test ( 13 C-MBT) is a dynamic method for assessing liver function. This proof-of-concept study aimed to investigate the association between 13 C-MBT values and outcomes in patients with hepatocellular carcinoma ( ... ...
| Abstract | Introduction: The 13 C-methacetin breath test ( 13 C-MBT) is a dynamic method for assessing liver function. This proof-of-concept study aimed to investigate the association between 13 C-MBT values and outcomes in patients with hepatocellular carcinoma (HCC) undergoing transarterial chemoembolization (TACE). Methods: A total of 30 patients with HCC were prospectively recruited. Of these, 25 were included in baseline and 20 in longitudinal analysis. 13 C-MBTs were performed before the first and second TACE session. Patients were followed for at least 1 year. Results: At baseline, the median 13 C-MBT value was 261 μg/kg/hr (interquartile range 159-387). 13 C-MBT, albumin-bilirubin, Child-Pugh, and Model for End-Stage Liver Disease scores were associated with overall survival in extended univariable Cox regression ( 13 C-MBT: standardized hazard ratio [sHR] 0.297, 95% confidence interval [CI] 0.111-0.796; albumin-bilirubin score: sHR 4.051, 95% CI 1.813-9.052; Child-Pugh score: sHR 2.616, 95% CI 1.450-4.719; Model for End-Stage Liver Disease score: sHR 2.781, 95% CI 1.356-5.703). Using a cutoff of 140 μg/kg/hr at baseline, 13 C-MBT was associated with prognosis (median overall survival 28.5 months [95% CI 0.0-57.1] vs 3.5 months [95% CI 0.0-8.1], log-rank P < 0.001). Regarding prediction of 90-day mortality after second 13 C-MBT, the relative change in 13 C-MBT values yielded an area under the receiver-operating characteristic curve of 1.000 ( P = 0.007). Discussion: Baseline and longitudinal 13 C-MBT values predict survival of patients with HCC undergoing TACE. The relative change in 13 C-MBT values predicts short-term mortality and may assist in identifying patients who will not benefit from further TACE treatment. |
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| MeSH term(s) | Humans ; Carcinoma, Hepatocellular/diagnosis ; Carcinoma, Hepatocellular/therapy ; Chemoembolization, Therapeutic/methods ; End Stage Liver Disease ; Liver Neoplasms/diagnosis ; Liver Neoplasms/therapy ; Treatment Outcome ; Severity of Illness Index ; Bilirubin ; Albumins ; Breath Tests |
| Chemical Substances | methacetin (13E468TFHP) ; Bilirubin (RFM9X3LJ49) ; Albumins |
| Language | English |
| Publishing date | 2022-10-01 |
| Publishing country | United States |
| Document type | Journal Article ; Research Support, Non-U.S. Gov't |
| ZDB-ID | 2581516-7 |
| ISSN | 2155-384X ; 2155-384X |
| ISSN (online) | 2155-384X |
| ISSN | 2155-384X |
| DOI | 10.14309/ctg.0000000000000529 |
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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