A simple prognostic scoring system for patients receiving transarterial embolisation for hepatocellular cancer.



Kadalayil, L, Benini, R, Pallan, L, O'Beirne, J ORCID: 0000-0003-3400-2816, Marelli, L, Yu, D, Hackshaw, A, Fox, R, Johnson, P ORCID: 0000-0003-1404-0209, Burroughs, AK
et al (show 2 more authors) (2013) A simple prognostic scoring system for patients receiving transarterial embolisation for hepatocellular cancer. Annals of oncology : official journal of the European Society for Medical Oncology, 24 (10). 2565 - 2570.

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Abstract

<h4>Background</h4>The prognosis for patients with hepatocellular cancer (HCC) undergoing transarterial therapy (TACE/TAE) is variable.<h4>Methods</h4>We carried out Cox regression analysis of prognostic factors using a training dataset of 114 patients treated with TACE/TAE. A simple prognostic score (PS) was developed, validated using an independent dataset of 167 patients and compared with Child-Pugh, CLIP, Okuda, Barcelona Clinic Liver Cancer (BCLC) and MELD.<h4>Results</h4>Low albumin, high bilirubin or α-fetoprotein (AFP) and large tumour size were associated with a two- to threefold increase in the risk of death. Patients were assigned one point if albumin <36 g/dl, bilirubin >17 μmol/l, AFP >400 ng/ml or size of dominant tumour >7 cm. The Hepatoma arterial-embolisation prognostic (HAP) score was calculated by summing these points. Patients were divided into four risk groups based on their HAP scores; HAP A, B, C and D (scores 0, 1, 2 and >2, respectively). The median survival for the groups A, B, C and D was 27.6, 18.5, 9.0 and 3.6 months, respectively. The HAP score validated well with the independent dataset and performed better than other scoring systems in differentiating high- and low-risk groups.<h4>Conclusions</h4>The HAP score predicts outcomes in patients with HCC undergoing TACE/TAE and may help guide treatment selection, allow stratification in clinical trials and facilitate meaningful comparisons across reported series.

Item Type: Article
Uncontrolled Keywords: Humans, Carcinoma, Hepatocellular, Liver Neoplasms, Bilirubin, Doxorubicin, Ethiodized Oil, Albumins, Serum Albumin, alpha-Fetoproteins, Antibiotics, Antineoplastic, Prognosis, Treatment Outcome, Embolization, Therapeutic, Adult, Aged, Aged, 80 and over, Middle Aged, Female, Male, Young Adult, Biomarkers, Tumor
Depositing User: Symplectic Admin
Date Deposited: 19 Aug 2016 08:39
Last Modified: 06 Oct 2022 06:14
DOI: 10.1093/annonc/mdt247
Open Access URL: http://10.0.4.69/annonc/mdt247
URI: https://livrepository.liverpool.ac.uk/id/eprint/3002908