title: Serum transferrin as a predictor of prognosis for hepatic arterial infusion chemotherapy in advanced hepatocellular carcinoma.
abstract: OBJECTIVE
  We recently reported that the iron chelator deferoxamine (DFO) is efficacious in advanced hepatocellular carcinoma (HCC) patients. Iron regulation may thus have an important impact in HCC therapy. Because transferrin is a native chelator that regulates iron homeostasis, it may act as an anticancer agent in a similar manner as DFO. The objective of this study was to evaluate serum transferrin as a prognostic predictor in advanced HCC patients undergoing hepatic arterial infusion chemotherapy (HAIC).
  
  
  METHODS
  We retrospectively studied 44 patients receiving HAIC and analyzed various parameters for their possible use as prognostic predictors.
  
  
  RESULTS
  The 1-, 2- and 3-year cumulative survival rates were 36.4%, 18.2% and 8.5%, respectively, and the median survival time (MST) was 7.0 months. The survival rates of patients who had serum transferrin of 190 mg/dL or more (MST, 12.0 months) were significantly better than those of patients who had serum transferrin of less than 190 mg/dL (MST, 4.9 months). Multivariate analysis identified serum transferrin of 190 mg/dL or more (hazard ratio [HR], 0.282; 95% confidence interval [CI], 0.132-0.603; P = 0.001) and Child-Pugh score B (HR, 1.956; 95% CI, 1.034-3.700; P = 0.039) as independent prognostic predictors. There was a significant correlation between serum transferrin level and therapeutic effect (P < 0.001).
  
  
  CONCLUSIONS
  Serum transferrin could be useful as a prognostic predictor in advanced HCC patients before HAIC treatment.
authors.affiliation: Department of Gastroenterology and Hepatology, Yamaguchi University Graduate School of Medicine, Ube, Japan.
authors.forename: Junichi
authors.initials: J
authors.lastname: Zaitsu
authors.forename: Takahiro
authors.initials: T
authors.lastname: Yamasaki
authors.forename: Issei
authors.initials: I
authors.lastname: Saeki
authors.forename: Yohei
authors.initials: Y
authors.lastname: Harima
authors.forename: Takuya
authors.initials: T
authors.lastname: Iwamoto
authors.forename: Yumiko
authors.initials: Y
authors.lastname: Harima
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Matsumoto
authors.forename: Yohei
authors.initials: Y
authors.lastname: Urata
authors.forename: Isao
authors.initials: I
authors.lastname: Hidaka
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Marumoto
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Ishikawa
authors.forename: Taro
authors.initials: T
authors.lastname: Takami
authors.forename: Naoki
authors.initials: N
authors.lastname: Yamamoto
authors.forename: Seiji
authors.initials: S
authors.lastname: Kaino
authors.forename: Koichi
authors.initials: K
authors.lastname: Uchida
authors.forename: Shuji
authors.initials: S
authors.lastname: Terai
authors.forename: Isao
authors.initials: I
authors.lastname: Sakaida
keywords: advanced hepatocellular carcinoma; hepatic arterial infusion chemotherapy; iron; prognostic predictor; serum transferrin