Park, Yehyun; Kim, Seung Up; Kim, Beom Kyung; Park, Jun Yong; Kim, Do Young; Ahn, Sang Hoon; Park, Yong Eun; Park, Ji Hye; Lee, Yong Il; Yun, Hae Ryong; Han, Kwang-Hyub
Liver international : official journal of the International Association for the Study of the Liver
2016Jan ; 36 ( 1 ) :100-7.
PMID : 26013186
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Park, Yehyun -
Kim, Seung Up -
Kim, Beom Kyung -
Park, Jun Yong -
Kim, Do Young -
Ahn, Sang Hoon -
Park, Yong Eun -
Park, Ji Hye -
Lee, Yong Il -
Yun, Hae Ryong -
Han, Kwang-Hyub -
ABSTRACT
BACKGROUND & AIMS: The hepatoma arterial-embolization prognostic (HAP) score predicts survival outcome in patients with hepatocellular carcinoma (HCC) treated with trans-arterial chemoembolization (TACE). We validated the HAP score in Korean subjects with HCC and investigated whether its prognostic performance is improved with additional parameters.
METHODS: A total of 280 patients with HCC treated with TACE between 2003 and 2009 were included. Validation and modification of HAP score were performed based on multivariate Cox regression models.
RESULTS: The median age of the study population (211 men, 69 women) was 60 years. Viral etiology of HCC accounted for 80.4% (n = 181 for hepatitis B, 44 for hepatitis C). The median overall survival (OS) was 40.5 months. On multivariate analysis, together with the original components of the HAP score (serum albumin <3.6 g/dl, total bilirubin >0.9 mg/dl, alpha-foetoprotein >400 ng/ml, and tumor size >7 cm), tumor number ?? was selected as an independent unfavorable prognostic factor for OS (hazard ratio 2.3; P < 0.001). Accordingly, a modified HAP-II (mHAP-II) score was established by adding tumor number ??. Although both HAP and mHAP-II scores discriminated the four different risk groups (log-rank test, all P < 0.001), the mHAP-II score performed significantly better than the HAP score, as per the areas under receiver-operating curves predicting OS at 3 years (0.717 vs. 0.658) and 5 years (0.728 vs. 0.645), respectively (all P < 0.05).
CONCLUSIONS: Although the HAP score predicted OS for Korean subjects with HCC undergoing TACE, the addition of tumor number significantly improved the prognostic performance. The mHAP-II score can be used for accurate prognostication and selection of optimal candidates for TACE. CI - ??2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
keyword
hepatocellular carcinoma; model; overall survival; prediction; prognosis; trans-arterial chemoembolization
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