O3- RECOMPENSATION IN PATIENTS WITH CIRRHOSIS PRIOR TO FIRST LINE SYSTEMIC THERAPY IS ASSOCIATED WITH SIMILAR SURVIVAL OUTCOMES COMPARED TO COMPENSATED CIRRHOSIS
Conflict of interest: No Introduction and Objectives: The term “recompensation” of cirrhosis was proposed in the latest BAVENO VII, underlying dynamic events and prognosis in cirrhosis. However, there is uncertainty regarding its prognosis in patients with advanced hepatocellular carcinoma (HCC) tre...
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Elsevier
2024-12-01
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| Series: | Annals of Hepatology |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1665268124003818 |
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| author | FEDERICO PIÑERO Margarita Anders Carla Bermúdez Diego Arufe Adriana Varón Ana Palazzo Jorge Rodriguez Oscar Beltrán Daniela Simian Leonardo Gomes da Fonseca Ezequiel Ridruejo Norberto Tamagnone Hugo Cheinquer Diana Bejarano Juan Ignacio Marín Federico Orozco Ganem Josefina Pagés Jaime Poniachik Sebastián Marciano Virginia Reggiardo Manuel Mendizabal |
| author_facet | FEDERICO PIÑERO Margarita Anders Carla Bermúdez Diego Arufe Adriana Varón Ana Palazzo Jorge Rodriguez Oscar Beltrán Daniela Simian Leonardo Gomes da Fonseca Ezequiel Ridruejo Norberto Tamagnone Hugo Cheinquer Diana Bejarano Juan Ignacio Marín Federico Orozco Ganem Josefina Pagés Jaime Poniachik Sebastián Marciano Virginia Reggiardo Manuel Mendizabal |
| author_sort | FEDERICO PIÑERO |
| collection | DOAJ |
| description | Conflict of interest: No Introduction and Objectives: The term “recompensation” of cirrhosis was proposed in the latest BAVENO VII, underlying dynamic events and prognosis in cirrhosis. However, there is uncertainty regarding its prognosis in patients with advanced hepatocellular carcinoma (HCC) treated with first line systemic therapies (1L). We aimed to compare post-1L survival between compensated (CC), decompensated (DC), and recompensated (RC) cirrhosis. Patients / Materials and Methods: A multicenter prospective Latin-American cohort study including advanced HCC patients with cirrhosis who received any 1L was conducted from 2018 to 2024. Three groups were defined: CC (had never presented decompensation); DC (presenting any decompensated event associated with portal hypertension at time of 1L), and RC group (prior history of any decompensation event at HCC diagnosis who were compensated at time of 1L). Survival since date of 1L was compared using Cox proportional hazard analysis. Results and Discussion: Overall, 306 patients received 1L, including sorafenib 60.5%, atezolizumab + bevacizumab 29.7%, lenvatinib 9.1%, and nivo/pembrolizumab 0.6%. Of these, 83.3% presented cirrhosis. Median 1L treatment duration was 5.1 months with a median overall survival since 1L of 16.0 months (range 12.9-18.3). Significant differences were observed between CC (n=167), DC (n=31) and RC (n=42) groups (Table). In the RC group, median time from decompensation to recompensation was 12.0 months (range 1.9-25.9); being ascites the most frequent event (78.6%). DC group presented decreased post-1L survival [median 8.6 months vs 17.2 months in CC [adjusted HR 1.9 (95% CI 1.05-3.5); P=0.03], while no significant survival difference was observed between RC and CC [median survival 12.5 months; aHR 1.3 (95% CI 0.81-2.1); P=0.28] (Figure). Lower access to second line therapy was observed in DC group. Conclusions: Patients with cirrhosis and advanced HCC who achieve recompensation may benefit from systemic therapies. This demands an observation period of follow up before precluding 1L in decompensated cirrhosis. |
| format | Article |
| id | doaj-art-47ffc5b43a5c48619b067fce6d8e0f8b |
| institution | OA Journals |
| issn | 1665-2681 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Elsevier |
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| series | Annals of Hepatology |
| spelling | doaj-art-47ffc5b43a5c48619b067fce6d8e0f8b2025-08-20T02:20:33ZengElsevierAnnals of Hepatology1665-26812024-12-012910159810.1016/j.aohep.2024.101598O3- RECOMPENSATION IN PATIENTS WITH CIRRHOSIS PRIOR TO FIRST LINE SYSTEMIC THERAPY IS ASSOCIATED WITH SIMILAR SURVIVAL OUTCOMES COMPARED TO COMPENSATED CIRRHOSISFEDERICO PIÑERO0Margarita Anders1Carla Bermúdez2Diego Arufe3Adriana Varón4Ana Palazzo5Jorge Rodriguez6Oscar Beltrán7Daniela Simian8Leonardo Gomes da Fonseca9Ezequiel Ridruejo10Norberto Tamagnone11Hugo Cheinquer12Diana Bejarano13Juan Ignacio Marín14Federico Orozco Ganem15Josefina Pagés16Jaime Poniachik17Sebastián Marciano18Virginia Reggiardo19Manuel Mendizabal20HOSPITAL UNIVERSITARIO AUSTRAL, Pilar, ArgentinaHospital Alemán, Buenos Aires, ArgentinaHospital Italiano de Buenos Aires, Buenos Aires, ArgentinaSanatorio Sagrado Corazón, Buenos Aires, ArgentinaFundación Cardioinfantil, Bogotá, ColombiaHospital Padilla, Tucumán, ArgentinaHospital Central, Mendoza, ArgentinaFundación Cardioinfantil, Bogotá, ColombiaHospital Clínico de la Universidad de Chile, Santiago, ChileInstituto do Cancer do Estado de São Paulo, Hospital das Clínicas, Universidade São Paulo, Sao Paulo, BrasilCentro de Educación Médica e Investigaciones Clínicas (CEMIC), Buenos Aires, ArgentinaHospital Centenario, Rosario, ArgentinaHospital das Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, BrasilHospital Universitario Fundación Santa Fe de Bogotá, Bogotá, ColombiaHospital Pablo Tobón Uribe, Medellín, ColombiaHospital Alemán, Buenos Aires, ArgentinaHOSPITAL UNIVERSITARIO AUSTRAL, Pilar, ArgentinaHospital Clínico de la Universidad de Chile, Santiago, ChileHospital Italiano de Buenos Aires, Buenos Aires, ArgentinaHospital Centenario, Rosario, ArgentinaHOSPITAL UNIVERSITARIO AUSTRAL, Pilar, ArgentinaConflict of interest: No Introduction and Objectives: The term “recompensation” of cirrhosis was proposed in the latest BAVENO VII, underlying dynamic events and prognosis in cirrhosis. However, there is uncertainty regarding its prognosis in patients with advanced hepatocellular carcinoma (HCC) treated with first line systemic therapies (1L). We aimed to compare post-1L survival between compensated (CC), decompensated (DC), and recompensated (RC) cirrhosis. Patients / Materials and Methods: A multicenter prospective Latin-American cohort study including advanced HCC patients with cirrhosis who received any 1L was conducted from 2018 to 2024. Three groups were defined: CC (had never presented decompensation); DC (presenting any decompensated event associated with portal hypertension at time of 1L), and RC group (prior history of any decompensation event at HCC diagnosis who were compensated at time of 1L). Survival since date of 1L was compared using Cox proportional hazard analysis. Results and Discussion: Overall, 306 patients received 1L, including sorafenib 60.5%, atezolizumab + bevacizumab 29.7%, lenvatinib 9.1%, and nivo/pembrolizumab 0.6%. Of these, 83.3% presented cirrhosis. Median 1L treatment duration was 5.1 months with a median overall survival since 1L of 16.0 months (range 12.9-18.3). Significant differences were observed between CC (n=167), DC (n=31) and RC (n=42) groups (Table). In the RC group, median time from decompensation to recompensation was 12.0 months (range 1.9-25.9); being ascites the most frequent event (78.6%). DC group presented decreased post-1L survival [median 8.6 months vs 17.2 months in CC [adjusted HR 1.9 (95% CI 1.05-3.5); P=0.03], while no significant survival difference was observed between RC and CC [median survival 12.5 months; aHR 1.3 (95% CI 0.81-2.1); P=0.28] (Figure). Lower access to second line therapy was observed in DC group. Conclusions: Patients with cirrhosis and advanced HCC who achieve recompensation may benefit from systemic therapies. This demands an observation period of follow up before precluding 1L in decompensated cirrhosis.http://www.sciencedirect.com/science/article/pii/S1665268124003818 |
| spellingShingle | FEDERICO PIÑERO Margarita Anders Carla Bermúdez Diego Arufe Adriana Varón Ana Palazzo Jorge Rodriguez Oscar Beltrán Daniela Simian Leonardo Gomes da Fonseca Ezequiel Ridruejo Norberto Tamagnone Hugo Cheinquer Diana Bejarano Juan Ignacio Marín Federico Orozco Ganem Josefina Pagés Jaime Poniachik Sebastián Marciano Virginia Reggiardo Manuel Mendizabal O3- RECOMPENSATION IN PATIENTS WITH CIRRHOSIS PRIOR TO FIRST LINE SYSTEMIC THERAPY IS ASSOCIATED WITH SIMILAR SURVIVAL OUTCOMES COMPARED TO COMPENSATED CIRRHOSIS Annals of Hepatology |
| title | O3- RECOMPENSATION IN PATIENTS WITH CIRRHOSIS PRIOR TO FIRST LINE SYSTEMIC THERAPY IS ASSOCIATED WITH SIMILAR SURVIVAL OUTCOMES COMPARED TO COMPENSATED CIRRHOSIS |
| title_full | O3- RECOMPENSATION IN PATIENTS WITH CIRRHOSIS PRIOR TO FIRST LINE SYSTEMIC THERAPY IS ASSOCIATED WITH SIMILAR SURVIVAL OUTCOMES COMPARED TO COMPENSATED CIRRHOSIS |
| title_fullStr | O3- RECOMPENSATION IN PATIENTS WITH CIRRHOSIS PRIOR TO FIRST LINE SYSTEMIC THERAPY IS ASSOCIATED WITH SIMILAR SURVIVAL OUTCOMES COMPARED TO COMPENSATED CIRRHOSIS |
| title_full_unstemmed | O3- RECOMPENSATION IN PATIENTS WITH CIRRHOSIS PRIOR TO FIRST LINE SYSTEMIC THERAPY IS ASSOCIATED WITH SIMILAR SURVIVAL OUTCOMES COMPARED TO COMPENSATED CIRRHOSIS |
| title_short | O3- RECOMPENSATION IN PATIENTS WITH CIRRHOSIS PRIOR TO FIRST LINE SYSTEMIC THERAPY IS ASSOCIATED WITH SIMILAR SURVIVAL OUTCOMES COMPARED TO COMPENSATED CIRRHOSIS |
| title_sort | o3 recompensation in patients with cirrhosis prior to first line systemic therapy is associated with similar survival outcomes compared to compensated cirrhosis |
| url | http://www.sciencedirect.com/science/article/pii/S1665268124003818 |
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