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. 2021 Apr 30;41(4):BSR20201928.
doi: 10.1042/BSR20201928.

Development of a preoperative prognostic scoring system to predict benefits of hepatic resection in advanced hepatocellular carcinoma patients

Chang-Zhi Chen #  1 , Jian-Hong Zhong #  1 , Ya-Peng Qi  1 , Jie Zhang  1 , Tao Huang  2 , Liang Ma  1 , Le-Qun Li  1 , Tao Peng  3 , Bang-De Xiang  1
Affiliations

Development of a preoperative prognostic scoring system to predict benefits of hepatic resection in advanced hepatocellular carcinoma patients

Chang-Zhi Chen et al. Biosci Rep. .

Abstract

Objective: The present study aimed to identify risk factors for overall survival in advanced hepatocellular carcinoma (HCC) patients and establish a scoring system to select patients who would benefit from hepatic resection.

Methods: Survival curves were analyzed using the Kaplan-Meier method and log-rank test. The prognostic scoring system was developed from training cohort using a Cox-regression model and validated in a external validation cohort Results: There were 401 patients in the training cohort, 163 patients in the external validation cohorts. The training cohort median survival in all patients was 12 ± 1.07 months, rate of overall survival was 49.6% at 1 year, 25.0% at 3 years, and 18.0% at 5 years. A prognostic scoring system was established based on age, body mass index, alkaline phosphatase, tumor number and tumor capsule. Patients were classified as low- risk group(≤3.5) or high-risk group(>3.5). High-risk patients had a median survival of 9 months, compared with 23 months in low-risk patients. The area under the receiver operating characteristic curve (AUC) of the prognostic scoring system was 0.747 (0.694-0.801), which is significantly better than AFP, Child-Pugh and ALBI. The AUC of validation cohorts was 0.716 (0.63-0.803).

Conclusion: A prognostic scoring system for hepatic resection in advanced HCC patients has been developed based entirely on preoperative variables. Patients classified as low risk using this system may experience better prognosis after hepatic resection.

Keywords: Advanced hepatocellular carcinoma; Hepatic resection; Preoperative; Prognostic scoring system.

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Conflict of interest statement

The authors declare that there are no competing interests associated with the manuscript.

Figures

Figure 1
Figure 1. Survival curves of high-risk and low-risk groups
ROC curves of the five models to predict patients’ overall survival after resection: the prognostic scoring system, alpha-fetoprotein (AFP), Child-Pugh, albumin-bilirubin (ALBI), and the validation cohort.
Figure 2
Figure 2. Survival curves of high- (score>3.5) and low-risk (score≤3.5) groups
See this image and copyright information in PMC

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