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Hepatocellular carcinoma specific graded prognostic assessment can predict outcomes for patients with brain metastases from hepatocellular carcinoma.

 Seungtaek Lim  ;  Soohyeon Lee  ;  Jae Yun Lim  ;  Ji Soo Park  ;  Jin Sil Seong  ;  Won Seok Chang  ;  Kwang Hyub Han  ;  Hye Jin Choi 
 JOURNAL OF NEURO-ONCOLOGY, Vol.120(1) : 199-207, 2014 
Journal Title
Issue Date
Adolescent ; Adult ; Aged ; Brain Neoplasms/mortality ; Brain Neoplasms/secondary* ; Carcinoma, Hepatocellular/mortality ; Carcinoma, Hepatocellular/pathology* ; Female ; Follow-Up Studies ; Health Status Indicators* ; Humans ; Liver Neoplasms/mortality ; Liver Neoplasms/pathology* ; Male ; Middle Aged ; Multivariate Analysis ; Neoplasm Grading ; Prognosis ; Retrospective Studies ; Survival Rate ; Young Adult
Brain metastasis ; Hepatocellular carcinoma ; Prognostic factor
Stratifying patients with brain metastasis (BM) from hepatocellular carcinoma (HCC) by prognostic factors can be useful when making treatment decisions. Nevertheless, a diagnosis-specific graded prognostic assessment (GPA) for HCC has not been well established. We retrospectively reviewed the data from 118 HCC patients newly diagnosed with BM at the Yonsei University Health System between 1985 and 2011. After univariate and multivariate analyses of prognostic factors, those shown to significantly affect survival were used to develop a HCC-specific GPA (HCC-GPA) index. The median overall survival after BM in all patients was 6.1 weeks (95% confidence interval 4.8-7.4 weeks). Using the prognostic factors identified via multivariate analysis, we developed a HCC-GPA index, including number of brain metastases (single: 0.5, multiple: 0 points), alpha-feto protein (<400 ng/mL: 0.5, ≥400 ng/mL: 0 points), and Child-Pugh-Score (A: 3, B: 2, C: 0 points). There were no survival differences for age, sex, performance status, and time interval from initial diagnosis to development of BM. Median survival times from BM were discriminable when applying the HCC-GPA scoring system: 1.7, 3.2, 7.9, and 27.0 weeks for HCC-GPA scores of 0-1.0 (N = 16), 1.5-2.5 (N = 32), 3.0-3.5 (N = 49), and 4.0 (N = 21), respectively (P < 0.001). Although the prognoses of patients with BM from HCC are dismal, the newly developed HCC-GPA index can be used to discriminate the expected prognoses thereof. Moreover, the index may hold value as a tool for selecting patients who may be good candidates for active local treatment.
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Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Neurosurgery (신경외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiation Oncology (방사선종양학교실) > 1. Journal Papers
Yonsei Authors
Park, Ji Soo(박지수) ORCID logo https://orcid.org/0000-0002-0023-7740
Seong, Jin Sil(성진실) ORCID logo https://orcid.org/0000-0003-1794-5951
Lee, Soo Hyeon(이수현)
Lim, Seung Taek(임승택)
Lim, Jae Yun(임재윤)
Chang, Won Seok(장원석) ORCID logo https://orcid.org/0000-0003-3145-4016
Choi, Hye Jin(최혜진) ORCID logo https://orcid.org/0000-0001-5917-1400
Han, Kwang-Hyub(한광협) ORCID logo https://orcid.org/0000-0003-3960-6539
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