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A prognostic score for patients with intermediate-stage hepatocellular carcinoma treated with transarterial chemoembolization.


ABSTRACT:

Background

Intermediate-stage hepatocellular carcinoma (HCC), defined according to the Barcelona Clinic Liver Cancer (BCLC) staging system, is a heterogeneous condition with variable clinical benefits from transarterial chemoembolization (TACE). This study aimed to develop a simple validated prognostic score based on the predictive factors for survival in patients with intermediate-stage HCC treated with TACE.

Methods

Three-hundred and fifty patients with intermediate-stage HCC undergoing initial TACE at Chiba University Hospital (training cohort; n = 187) and two affiliated hospitals (validation cohort; n = 163) were included. Following variables were entered into univariate and multivariate Cox regression models to develop a points-based clinical scoring system: gender, age, etiology, pretreatment, Child-Pugh score, aspartate aminotransferase, creatinine, C-reactive protein, alfa-fetoprotein, size of the largest lesion, and number and location of lesions.

Results

The number of lesions and the Child-Pugh score were identified as independent prognostic factors in the training cohort. The development of a 0-7-point prognostic score, named the Chiba HCC in intermediate-stage prognostic (CHIP) score, was based on the sum of three subscale scores (Child-Pugh score = 0, 1, 2, or 3, respectively, number of lesions = 0, 2, or 3, respectively, HCV-RNA positivity = 0 or 1, respectively). The generated scores were then differentiated into five groups (0-2 points, 3 points, 4 points, 5 points, and 6-7 points) by the median survival time (65.2, 29.2, 24.3, 13.1, and 8.4 months, respectively; p < 0.0001). These results were confirmed in the external validation cohort (p < 0.0001).

Conclusions

The CHIP score is easy-to-use and may assist in finding an appropriate treatment strategy for intermediate-stage HCC.

SUBMITTER: Ogasawara S 

PROVIDER: S-EPMC4412579 | biostudies-literature | 2015

REPOSITORIES: biostudies-literature

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Publications

A prognostic score for patients with intermediate-stage hepatocellular carcinoma treated with transarterial chemoembolization.

Ogasawara Sadahisa S   Chiba Tetsuhiro T   Ooka Yoshihiko Y   Kanogawa Naoya N   Motoyama Tenyu T   Suzuki Eiichiro E   Tawada Akinobu A   Azemoto Ryosaku R   Shinozaki Masami M   Yoshikawa Masaharu M   Yokosuka Osamu O  

PloS one 20150428 4


<h4>Background</h4>Intermediate-stage hepatocellular carcinoma (HCC), defined according to the Barcelona Clinic Liver Cancer (BCLC) staging system, is a heterogeneous condition with variable clinical benefits from transarterial chemoembolization (TACE). This study aimed to develop a simple validated prognostic score based on the predictive factors for survival in patients with intermediate-stage HCC treated with TACE.<h4>Methods</h4>Three-hundred and fifty patients with intermediate-stage HCC un  ...[more]

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