Development of a Novel Comprehensive Hepatocellular Carcinoma Outcome Prognostic Scoring System With Integration of Imaging Features.

Autor:	Tran Cao HS; Department of Surgical Oncology, U.T. MD Anderson Cancer Center, Houston, TX, USA., Witt RG; Department of Surgical Oncology, U.T. MD Anderson Cancer Center, Houston, TX, USA.; Department of Surgery, University of Virginia, Charlottesville, VA, USA., Elsayes KM; Department of Abdominal Imaging, U.T. MD Anderson Cancer Center, Houston, TX, USA., Baiomy AA; Department of Interventional Radiology, Texas Tech University Health Sciences Center, El Paso, TX, USA., Xiao L; Department of Biostatistics, U.T. MD Anderson Cancer Center, Houston, TX, USA., Palmquist S; Department of Abdominal Imaging, U.T. MD Anderson Cancer Center, Houston, TX, USA., Lee SS; Department of GI Medical Oncology, U.T. MD Anderson Cancer Center, Houston, TX, USA., Mohamed YI; Department of GI Medical Oncology, U.T. MD Anderson Cancer Center, Houston, TX, USA., Mahvash A; Department of Interventional Radiology, U.T. MD Anderson Cancer Center, Houston, TX, USA., Tzeng CD; Department of Surgical Oncology, U.T. MD Anderson Cancer Center, Houston, TX, USA., Chun YS; Department of Surgical Oncology, U.T. MD Anderson Cancer Center, Houston, TX, USA., Koay EJ; Department of Radiation Oncology, U.T. MD Anderson Cancer Center, Houston, TX, USA., Rashid A; Department of Pathology, U.T. MD Anderson Cancer Center, Houston, TX, USA., Hassan MM; Department of Epidemiology, U.T. MD Anderson Cancer Center, Houston, TX, USA., Yao JC; Department of GI Medical Oncology, U.T. MD Anderson Cancer Center, Houston, TX, USA., Vauthey JN; Department of Surgical Oncology, U.T. MD Anderson Cancer Center, Houston, TX, USA., Kaseb AO; Department of GI Medical Oncology, U.T. MD Anderson Cancer Center, Houston, TX, USA.
Jazyk:	angličtina
Zdroj:	The oncologist [Oncologist] 2024 Jun 03; Vol. 29 (6), pp. e803-e810.
DOI:	10.1093/oncolo/oyad329
Abstrakt:	Background: Accurate prognostic stratification of hepatocellular carcinoma (HCC) is vital for clinical trial enrollment and treatment allocation. Multiple scoring systems have been created to predict patient survival, but no standardized scoring systems account for radiologic tumor features. We sought to create a generalizable scoring system for HCC which incorporates standardized radiologic tumor features and more accurately predicts overall survival (OS) than established systems. Methods: Clinicopathologic parameters were collected from a prospectively collected cohort of patients with HCC treated at a single institution. Imaging studies were evaluated for tumor characteristics. Patients were randomly divided into a training set for identification of covariates that impacted OS and a validation set. Cox models were used to determine the association of various factors with OS and a scoring system was created. Results: We identified 383 patients with HCC with imaging and survival outcomes, n = 255 in the training set and 128 in the validation cohort. Factors associated with OS on multivariate analysis included: tumor margin appearance on CT or MRI (hazard ratio [HR] 1.37, 95% CI, 1.01-1.88) with infiltrative margins portending worse outcomes than encapsulated margins, massive tumor morphology (HR 1.64, 95% CI, 1.06-2.54); >2 lesions (HR 2.06, 95% CI, 1.46-2.88), Child-Turcotte-Pugh class C (HR 3.7, 95% CI, 2.23-6.16), and portal vein thrombus (HR 2.41, 95% CI, 1.71-3.39). A new scoring system was developed and more predictive of OS than other well-established systems. Conclusions: Incorporation of standardized imaging characteristics to established clinical and lab predictors of outcome resulted in an improved predictive scoring system for patients with HCC. (© The Author(s) 2023. Published by Oxford University Press.)
Databáze:	MEDLINE
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