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Sub-classification of Advanced-Stage Hepatocellular Carcinoma: A Cohort Study Including 612 Patients Treated with Sorafenib

Title
Sub-classification of Advanced-Stage Hepatocellular Carcinoma: A Cohort Study Including 612 Patients Treated with Sorafenib
Authors
Yoo, Jeong-JuChung, Goh EunLee, Jeong-HoonNam, Joon YeulChang, YoungLee, Jeong MinLee, Dong HoKim, Hwi YoungCho, Eun JuYu, Su JongKim, Yoon JunYoon, Jung-HwanSeoul Liver Grp
Ewha Authors
김희영
Issue Date
2018
Journal Title
CANCER RESEARCH AND TREATMENT
ISSN
1598-2998JCR Link2005-9256JCR Link
Citation
vol. 50, no. 2, pp. 366 - 373
Keywords
Hepatocellular carcinomaAdvanced-stageSorafenibPrognosis
Publisher
KOREAN CANCER ASSOCIATION
Indexed
SCIE; SCOPUS; KCI WOS scopus
Abstract
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.
DOI
10.4143/crt.2017.126
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연구기관 > 의과학연구소 > Journal papers
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