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Survival Estimates after Stopping Sorafenib in Patients with Hepatocellular Carcinoma: NEXT Score Development and Validation

 Hye Won Lee  ;  Hyun Soo Kim  ;  Seung Up Kim  ;  Do Young Kim  ;  Beom Kyung Kim  ;  Jun Yong Park  ;  Sang Hoon Ahn  ;  Mi Young Jeon  ;  Ja Yoon Heo  ;  Soo Young Park  ;  Yu Rim Lee  ;  Sun Kyung Jang  ;  Su Hyun Lee  ;  Se Young Jang  ;  Won Young Tak  ;  Kwang-Hyub Han 
 GUT AND LIVER, Vol.11(5) : 693-701, 2017 
Journal Title
Issue Date
Aged ; Antineoplastic Agents* ; Area Under Curve ; Carcinoma, Hepatocellular/drug therapy ; Carcinoma, Hepatocellular/mortality* ; Female ; Humans ; Liver Neoplasms/drug therapy ; Liver Neoplasms/mortality* ; Male ; Middle Aged ; Niacinamide/analogs & derivatives* ; Phenylurea Compounds* ; ROC Curve ; Retrospective Studies ; Risk Factors ; Severity of Illness Index* ; Survival Rate ; Withholding Treatment/statistics & numerical data*
Hepatocellular carcinoma ; Prediction ; Risk ; Sorafenib ; Survival
Background/Aims: Limited information is available regarding patient survival after sorafenib discontinuation in patients with hepatocellular carcinoma (HCC). Thus, we developed and validated a novel survival prediction model.

Methods: Clinical data from 409 patients with HCC who stopped taking sorafenib between September 2008 and February 2015 were reviewed.

Results: In the training cohort, four factors were independent negative predictors of survival (p<0.05). Based on the β regression coefficient of each factor, we established the NEXT score (Survival after Stopping Nexavar Treatment), allocating 1 point each for an Eastern Cooperative Oncology Group score ≥2, Child-Pugh class B or C, serum sodium ≤135 mEq/L, and α-fetoprotein 〉400 ng/mL. Area under the receiver operating characteristic curve values to predict 1-, 3-, and 6-month survival rates were 0.805, 0.809, and 0.774, respectively, in the training cohort and 0.783, 0.728, and 0.673, respectively, in the validation cohort (n=137). When the training and validation cohorts were stratified into three risk groups (NEXT score 0 [low-risk] vs 1 to 2 [intermediate-risk] vs 3 to 4 [high-risk]), survival differed significantly between the groups (p<0.05, log-rank test).

Conclusions: In patients with HCC, survival after stopping sorafenib is poor. However, risk estimates based on a new "NEXT score" may help predict survival and prognosis even in patients who discontinue sorafenib treatment.
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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
Lee, Hye Won(이혜원) ORCID logo https://orcid.org/0000-0002-3552-3560
Jeon, Mi Young(전미영) ORCID logo https://orcid.org/0000-0002-3980-4503
Han, Kwang-Hyub(한광협) ORCID logo https://orcid.org/0000-0003-3960-6539
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