Sub-classification of Advanced-Stage Hepatocellular Carcinoma: A Cohort Study Including 612 Patients Treated with Sorafenib
- 주제(키워드) Hepatocellular carcinoma , Advanced-stage , Sorafenib , Prognosis
- 주제(기타) Oncology
- 설명문(일반) [Yoo, Jeong-Ju; Lee, Jeong-Hoon; Nam, Joon Yeul; Chang, Young; Cho, Eun Ju; Yu, Su Jong; Kim, Yoon Jun; Yoon, Jung-Hwan] Seoul Natl Univ, Coll Med, Dept Internal Med, Seoul, South Korea; [Yoo, Jeong-Ju; Lee, Jeong-Hoon; Nam, Joon Yeul; Chang, Young; Cho, Eun Ju; Yu, Su Jong; Kim, Yoon Jun; Yoon, Jung-Hwan] Seoul Natl Univ, Coll Med, Liver Res Inst, Seoul, South Korea; [Yoo, Jeong-Ju] Soonchunhyang Univ, Bucheon Hosp, Dept Gastroenterol & Hepatol, Bucheon, South Korea; [Chung, Goh Eun] Seoul Natl Univ Hosp, Gangnam Healthcare Ctr, Healthcare Res Inst, Dept Internal Med, Seoul, South Korea; [Lee, Dong Ho] Seoul Natl Univ, Seoul Natl Univ Hosp, Dept Radiol, Coll Med, Seoul, South Korea; [Kim, Hwi Young] Ewha Womans Univ, Mokdong Hosp, Sch Med, Liver Ctr,Dept Internal Med, Seoul, South Korea
- 등재 SCIE, SCOPUS, KCI등재
- 발행기관 KOREAN CANCER ASSOCIATION
- 발행년도 2018
- URI http://www.dcollection.net/handler/ewha/000000160410
- 본문언어 영어
- Published As http://dx.doi.org/10.4143/crt.2017.126
초록/요약
Purpose Advanced hepatocellular carcinoma (HCC) is associated with various clinical conditions including major vessel invasion, metastasis, and poor performance status. The aim of this study was to establish a prognostic scoring system and to propose a sub-classification of the Barcelona-Clinic Liver Cancer (BCLC) stage C. Materials and Methods This retrospective study included consecutive patients who received sorafenib for BCLC stage C HCC at a single tertiary hospital in Korea. A Cox proportional hazard model was used to develop a scoring system, and internal validation was performed by a 5-fold cross-validation. The performance of the model in predicting risk was assessed by the area under the curve and the Hosmer-Lemeshow test. Results A total of 612 BCLC stage C HCC patients were sub-classified into strata depending on their performance status. Five independent prognostic factors (Child-Pugh score, alpha-fetoprotein, tumor type, extrahepatic metastasis, and portal vein invasion) were identified and used in the prognostic scoring system. This scoring system showed good discrimination (area under the receiver operating characteristic curve, 0.734 to 0.818) and calibration functions (both p < 0.05 by the Hosmer-Lemeshow test at 1 month and 12 months, respectively). The differences in survival among the different risk groups classified by the total score were significant (p < 0.001 by the log-rank test in both the Eastern Cooperative Oncology Group 0 and 1 strata). Conclusion The heterogeneity of patients with BCLC stage C HCC requires sub-classification of advanced HCC. A prognostic scoring system with five independent factors is useful in predicting the survival of patients with BCLC stage C HCC.
more