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Development and Validation of a New Prognostic System for Patients with Hepatocellular Carcinoma

Authors :
Farinati, Fabio
Vitale, Alessandro
Spolverato, Gaya
Pawlik, Timothy M.
Huo, Teh-La
Lee, Yun-Hsuan
Frigo, Anna Chiara
Giacomin, Anna
Giannini, Edoardo G.
Ciccarese, Francesca
Piscaglia, Fabio
Rapaccini, Gian Ludovico
Di Marco, Mariella
Caturelli, Eugenio
Zoli, Marco
Borzio, Franco
Cabibbo, Giuseppe
Felder, Martina
Sacco, Rodolfo
Morisco, Filomena
Biasini, Elisabetta
Foschi, Francesco Giuseppe
Gasbarrini, Antonio
Svegliati Baroni, Gianluca
Virdone, Roberto
Masotto, Alberto
Trevisani, Franco
Cillo, Umberto
Rapaccini, Gian Ludovico (ORCID:0000-0002-6467-857X)
Gasbarrini, Antonio (ORCID:0000-0002-7278-4823)
Farinati, Fabio
Vitale, Alessandro
Spolverato, Gaya
Pawlik, Timothy M.
Huo, Teh-La
Lee, Yun-Hsuan
Frigo, Anna Chiara
Giacomin, Anna
Giannini, Edoardo G.
Ciccarese, Francesca
Piscaglia, Fabio
Rapaccini, Gian Ludovico
Di Marco, Mariella
Caturelli, Eugenio
Zoli, Marco
Borzio, Franco
Cabibbo, Giuseppe
Felder, Martina
Sacco, Rodolfo
Morisco, Filomena
Biasini, Elisabetta
Foschi, Francesco Giuseppe
Gasbarrini, Antonio
Svegliati Baroni, Gianluca
Virdone, Roberto
Masotto, Alberto
Trevisani, Franco
Cillo, Umberto
Rapaccini, Gian Ludovico (ORCID:0000-0002-6467-857X)
Gasbarrini, Antonio (ORCID:0000-0002-7278-4823)
Publication Year :
2016

Abstract

Background: Prognostic assessment in patients with hepatocellular carcinoma (HCC) remains controversial. Using the Italian Liver Cancer (ITA.LI.CA) database as a training set, we sought to develop and validate a new prognostic system for patients with HCC. Methods and Findings: Prospective collected databases from Italy (training cohort, n = 3,628; internal validation cohort, n = 1,555) and Taiwan (external validation cohort, n = 2,651) were used to develop the ITA.LI.CA prognostic system. We first defined ITA.LI.CA stages (0, A, B1, B2, B3, C) using only tumor characteristics (largest tumor diameter, number of nodules, intra- and extrahepatic macroscopic vascular invasion, extrahepatic metastases). A parametric multivariable survival model was then used to calculate the relative prognostic value of ITA.LI.CA tumor stage, Eastern Cooperative Oncology Group (ECOG) performance status, Child–Pugh score (CPS), and alpha-fetoprotein (AFP) in predicting individual survival. Based on the model results, an ITA.LI.CA integrated prognostic score (from 0 to 13 points) was constructed, and its prognostic power compared with that of other integrated systems (BCLC, HKLC, MESIAH, CLIP, JIS). Median follow-up was 58 mo for Italian patients (interquartile range, 26–106 mo) and 39 mo for Taiwanese patients (interquartile range, 12–61 mo). The ITA.LI.CA integrated prognostic score showed optimal discrimination and calibration abilities in Italian patients. Observed median survival in the training and internal validation sets was 57 and 61 mo, respectively, in quartile 1 (ITA.LI.CA score ≤ 1), 43 and 38 mo in quartile 2 (ITA.LI.CA score 2–3), 23 and 23 mo in quartile 3 (ITA.LI.CA score 4–5), and 9 and 8 mo in quartile 4 (ITA.LI.CA score > 5). Observed and predicted median survival in the training and internal validation sets largely coincided. Although observed and predicted survival estimations were significantly lower (log-rank test, p < 0.001) in Italian than in Taiwanese pati

Details

Database :
OAIster
Notes :
English
Publication Type :
Electronic Resource
Accession number :
edsoai.on1105028995
Document Type :
Electronic Resource