Lai Y, Lee JC, Hung HC, Wang YC, Cheng CH, Wu TH, Lee CF, Wu TJ, Chou HS, Chan KM, Kao CY, Lee WC. Modified preoperative score to predict disease-free survival for hepatocellular carcinoma patients with surgical resections. World J Hepatol 2022; 14(9): 1778-1789 [PMID: 36185727 DOI: 10.4254/wjh.v14.i9.1778]
Corresponding Author of This Article
Wei-Chen Lee, MD, Professor, Division of Liver and Transplantation Surgery, Department of General Surgery, Chang-Gung Memorial Hospital, Chang-Gung University College of Medicine, No. 5 Fu-Hsing Street, Kwei-Shan, Taoyuan 333, Taiwan. weichen@cgmh.org.tw
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Yin Lai, Jin-Chiao Lee, Hao-Chien Hung, Yu-Chao Wang, Chih-Hsien Cheng, Tsung-Han Wu, Chen-Fang Lee, Ting-Jung Wu, Hong-Shiue Chou, Kun-Ming Chan, Wei-Chen Lee, Division of Liver and Transplantation Surgery, Department of General Surgery, Chang-Gung Memorial Hospital, Chang-Gung University College of Medicine, Taoyuan 333, Taiwan
Chen-Yao Kao, Department of Special Education, National University of Tainan, Tainan 700, Taiwan
Author contributions: Lai Y designed and performed the research and wrote the paper; Hung HC and Lee JC contributed to the analysis; Wang YC, Cheng CH, Wu TH, Lee CF, Wu TJ, Chou HS, and Chan KM provided clinical advice; Kao CY contributed to the final manuscript; Lee WC supervised the report.
Institutional review board statement: This study was approved by the local ethics committee of Chang Gung Memorial Hospital, No. 104-3900B.
Informed consent statement: Because of retrospective study, signed informed consent form is not needed. However, Chang-Gung Memorial Hospital has given permission to conduct this study.
Conflict-of-interest statement: The authors declare that there are no conflict of interests.
Data sharing statement: The data that support the findings of this study are available from the corresponding author, Lee WC, upon reasonable request.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Wei-Chen Lee, MD, Professor, Division of Liver and Transplantation Surgery, Department of General Surgery, Chang-Gung Memorial Hospital, Chang-Gung University College of Medicine, No. 5 Fu-Hsing Street, Kwei-Shan, Taoyuan 333, Taiwan. weichen@cgmh.org.tw
Received: January 12, 2022 Peer-review started: January 12, 2022 First decision: April 16, 2022 Revised: April 30, 2022 Accepted: August 22, 2022 Article in press: August 22, 2022 Published online: September 27, 2022 Processing time: 253 Days and 9.8 Hours
Abstract
BACKGROUND
No prognostic models specific to hepatocellular carcinoma patients receiving surgical resection have been considered strong and convincing enough for survival prediction thus far, and there are no models including only preoperative predictors. We derived a nomogram to predict disease-free survival in a previous study.
AIM
To simplify our score and compare research outcomes among other scoring systems.
METHODS
We retrospectively reviewed data from 1106 patients with hepatocellular carcinoma who underwent liver resection at the Linkou Chang Gung Memorial Hospital between April 2003 and December 2012. Multivariate analyses were conducted to identify the significant survival predictors. Homogeneity, Harrell’s C-index, and Akaike information criterion were compared between our score, AJCC 8th edition, Tokyo score, and Taipei Integrated Scoring System (TTV-CTP-AFP model).
RESULTS
Among the 1106 patients, 731 (66.1%) had tumor recurrence at a median follow-up of 83.9 mo. Five risk factors were identified: platelet count, albumin level, indocyanine green retention rate, multiplicity, and radiologic total tumor volume. Patients were divided into three risk groups, and the 5-year survival rates were 61.7%, 39%, and 25.7%, respectively. The C-index was 0.617, which was higher than the Tokyo score (0.613) and the Taipei Integrated Scoring System (0.562) and equal to the value of the AJCC 8th edition (0.617).
CONCLUSION
The modified score provides an easier method to predict survival. Appropriate treatment can be planned preoperatively by dividing patients into risk groups.
Core Tip: This retrospective study recruited over 1000 patients and developed a simple preoperative score to evaluate the recurrence risk of hepatocellular carcinoma after surgical resection. Despite the lack of pathological features, predictive power was satisfactory. Appropriate treatment can be planned preoperatively by dividing patients into risk groups.
