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Risk prediction for patients with hepatocellular carcinoma undergoing chemoembolization: development of a prediction model

 Beom Kyung Kim  ;  Ju Hyun Shim  ;  Seung Up Kim  ;  Jun Yong Park  ;  Do Young Kim  ;  Sang Hoon Ahn  ;  Kang Mo Kim  ;  Young-Suk Lim  ;  Kwang-Hyub Han  ;  Han Chu Lee 
 LIVER INTERNATIONAL, Vol.36(1) : 92-99, 2016 
Journal Title
Issue Date
Aged ; Biomarkers, Tumor/analysis ; Carcinoma, Hepatocellular*/diagnosis ; Carcinoma, Hepatocellular*/pathology ; Carcinoma, Hepatocellular*/therapy ; Chemoembolization, Therapeutic*/adverse effects ; Chemoembolization, Therapeutic*/methods ; Female ; Humans ; Liver Neoplasms*/diagnosis ; Liver Neoplasms*/pathology ; Liver Neoplasms*/therapy ; Male ; Middle Aged ; Models, Statistical ; Neoplasm Staging ; Predictive Value of Tests ; Prognosis ; ROC Curve ; Random Allocation ; Risk Assessment/methods* ; Treatment Outcome ; Tumor Burden ; alpha-Fetoproteins/analysis
hepatocellular carcinoma ; model ; prediction ; prognosis ; risk estimation ; transarterial chemoembolization
BACKGROUNDS & AIMS: We aimed to generate and validate a novel risk prediction model for patients with hepatocellular carcinoma (HCC) undergoing transarterial chemoembolization (TACE). METHODS: Patients receiving TACE as the first-line therapy between 2006 and 2009 were selected from the databases of two major tertiary hospitals in Korea. This study population was randomly assigned into training (n = 340) and validation (n = 145) sets. From a multivariate Cox-regression model for overall survival (OS), tumour Size, tumour Number, baseline Alpha-foetoprotein level, Child-Pugh class and Objective radiological Response after the first TACE session were selected and then scored to generate a 10-point risk prediction model (named as "SNACOR" model) in the training set. Thereafter, the prognostic performance was assessed in the validation set. RESULTS: In the training set, the time-dependent areas under receiver-operating characteristic curves (AUROCs) for OS at 1-, 3- and 6-years were 0.756, 0.754 and 0.742 respectively. According to the score of the SNACOR model, patients were stratified into three groups; low- (score 0-2), intermediate- (score 3-6) and high-risk group (score 7-10) respectively. The low-risk group had the longest median OS (49.8 months), followed by intermediate- (30.7 months) and high-risk group (12.4 months) (log-rank test, P < 0.001). Compared with the low-risk group, the intermediate-risk (hazard ratio [HR] 2.13, P < 0.001) and high-risk group (HR 6.17, P < 0.001) retained significant risks of death. Similar results were obtained in the validation set. CONCLUSION: A simple-to-use SNACOR model for patients with HCC treated with TACE might be helpful in appropriate prognostification and guidance for decision of further treatment strategies.
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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, Jun Yong(박준용) ORCID logo https://orcid.org/0000-0001-6324-2224
Ahn, Sang Hoon(안상훈) ORCID logo https://orcid.org/0000-0002-3629-4624
Han, Kwang-Hyub(한광협) ORCID logo https://orcid.org/0000-0003-3960-6539
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