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Addition of tumor multiplicity improves the prognostic performance of the hepatoma arterial-embolization prognostic score

Authors
 Yehyun Park  ;  Seung Up Kim  ;  Beom Kyung Kim  ;  Jun Yong Park  ;  Do Young Kim  ;  Sang Hoon Ahn  ;  Yong Eun Park  ;  Ji Hye Park  ;  Yong Il Lee  ;  Hae Ryong Yun  ;  Kwang-Hyub Han 
Citation
 Liver International, Vol.36(1) : 100-107, 2016 
Journal Title
 Liver International 
ISSN
 1478-3223 
Issue Date
2016
MeSH
Aged ; Biomarkers, Tumor/analysis ; Carcinoma, Hepatocellular*/diagnosis ; Carcinoma, Hepatocellular*/etiology ; Carcinoma, Hepatocellular*/mortality ; Carcinoma, Hepatocellular*/pathology ; Carcinoma, Hepatocellular*/therapy ; Chemoembolization, Therapeutic*/adverse effects ; Chemoembolization, Therapeutic*/methods ; Female ; Humans ; Liver Neoplasms*/diagnosis ; Liver Neoplasms*/etiology ; Liver Neoplasms*/mortality ; Liver Neoplasms*/pathology ; Liver Neoplasms*/therapy ; Male ; Middle Aged ; Neoplasm Staging ; Prognosis ; Proportional Hazards Models ; Republic of Korea ; Research Design/standards ; Risk Assessment/methods* ; Survival Analysis ; Tumor Burden ; alpha-Fetoproteins/analysis
Keywords
hepatocellular carcinoma ; model ; overall survival ; prediction ; prognosis ; trans-arterial chemoembolization
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 ≥2 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 ≥2. 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.
Full Text
http://onlinelibrary.wiley.com/doi/10.1111/liv.12878/abstract
DOI
10.1111/liv.12878
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Do Young(김도영)
Kim, Beom Kyung(김범경) ORCID logo https://orcid.org/0000-0002-5363-2496
Kim, Seung Up(김승업) ORCID logo https://orcid.org/0000-0002-9658-8050
Park, Yehyun(박예현) ORCID logo https://orcid.org/0000-0001-8811-0631
Park, Yong Eun(박용은)
Park, Jun Yong(박준용) ORCID logo https://orcid.org/0000-0001-6324-2224
Park, Ji Hye(박지혜)
Ahn, Sang Hoon(안상훈) ORCID logo https://orcid.org/0000-0002-3629-4624
Yun, Hae Ryong(윤해룡) ORCID logo https://orcid.org/0000-0002-7038-0251
Han, Kwang-Hyub(한광협) ORCID logo https://orcid.org/0000-0003-3960-6539
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/146425
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