Development of a preoperative prognostic scoring system to predict benefits of hepatic resection in advanced hepatocellular carcinoma patients

Autor: Le-Qun Li, Liang Ma, Jian-Hong Zhong, Bang-De Xiang, Jie Zhang, Tao Peng, Tao Huang, Ya-Peng Qi, Chang-Zhi Chen
Rok vydání: 2021
Předmět:
Adult
Male
Oncology
medicine.medical_specialty
Advanced hepatocellular carcinoma
Carcinoma
Hepatocellular
Scoring system
Adolescent
Tumor capsule
Hepatic resection
Biophysics
Biochemistry
Body Mass Index
03 medical and health sciences
Postoperative Complications
0302 clinical medicine
Internal medicine
Biomarkers
Tumor
medicine
Hepatectomy
Humans
Molecular Biology
Diagnostics & Biomarkers
Research Articles
Survival analysis
Cancer
Preoperative
Aged
Neoplasm Staging
Receiver operating characteristic
business.industry
Pharmacology & Toxicology
Liver Neoplasms
Age Factors
Cell Biology
Middle Aged
medicine.disease
Tumor Burden
030220 oncology & carcinogenesis
Hepatocellular carcinoma
Preoperative Period
Cohort
Prognostic scoring system
Female
030211 gastroenterology & hepatology
business
Body mass index
Zdroj: Bioscience Reports
ISSN: 1573-4935
0144-8463
DOI: 10.1042/bsr20201928
Popis: Objective: The present study aimed to identify risk factors for overall survival in advanced hepatocellular carcinoma (HCC) patients and establish a scoring system to select patients who would benefit from hepatic resection. Methods: Survival curves were analyzed using the Kaplan–Meier method and log-rank test. The prognostic scoring system was developed from training cohort using a Cox-regression model and validated in a external validation cohort Results: There were 401 patients in the training cohort, 163 patients in the external validation cohorts. The training cohort median survival in all patients was 12 ± 1.07 months, rate of overall survival was 49.6% at 1 year, 25.0% at 3 years, and 18.0% at 5 years. A prognostic scoring system was established based on age, body mass index, alkaline phosphatase, tumor number and tumor capsule. Patients were classified as low- risk group(≤3.5) or high-risk group(>3.5). High-risk patients had a median survival of 9 months, compared with 23 months in low-risk patients. The area under the receiver operating characteristic curve (AUC) of the prognostic scoring system was 0.747 (0.694–0.801), which is significantly better than AFP, Child-Pugh and ALBI. The AUC of validation cohorts was 0.716 (0.63–0.803). Conclusion: A prognostic scoring system for hepatic resection in advanced HCC patients has been developed based entirely on preoperative variables. Patients classified as low risk using this system may experience better prognosis after hepatic resection.
Databáze: OpenAIRE
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