scholarly journals Prognostic value of hepatocellular carcinoma staging systems: a comparison

HPB ◽  
2018 ◽  
Vol 20 ◽  
pp. S72
Author(s):  
S. Bergstresser ◽  
P. Li ◽  
K. Vines ◽  
B. Comeaux ◽  
J. Zarzour ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Prognostic Value ◽  
Staging Systems

Modified CLIP score with albumin-bilirubin grade in relation to prognostic value in HBV-related hepatocellular carcinoma patients treated with transcatheter arterial chemoembolization therapy.

2018 ◽  
Vol 36 (4_suppl) ◽  
pp. 480-480
Author(s):  
Xiu-Rong Cai ◽  
Zhan-Hong Chen ◽  
Qu Lin ◽  
Min Dong ◽  
Xiao-kun Ma ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Prognostic Value ◽  
Information Criterion ◽  
Roc Curves ◽  
Hepatic Function ◽  
Tnm Staging ◽  
Ratio Test ◽  
Tnm System ◽  
Staging Systems ◽  
Hepatic Function Reserve

480 Background: Child-Pugh grade is widely used to assess hepatic function reserve, but it is relatively subjective for assessment of hepatic encephalopathy. A newly developed scoring system combining albumin and bilirubin, called ALBI grade, aims to assess liver function objectively. In prognosis prediction of hepatocellular carcinoma (HCC), The Cancer of the Liver Italian Program (CLIP) score is commonly used in clinical practice and includes Child-Pugh evaluation. We substituted ALBI grade for Child-Pugh grade to establish ALBI-CLIP system and conducted this study to validate the prognostic value of ALBI -CLIP in HBV-related HCC patients after TACE therapy. Methods: We retrospectively analyzed HBV-related HCC patients who received TACE therapy. Baseline data were collected and evaluated. Child-Pugh grade and ALBI grade were integrated into CLIP and ALBI-CLIP systems, respectively. Univariate and multivariate analyses were conducted to identify independent prognostic factors for overall survival. Comparisons of receiver operating characteristic (ROC) curves and likelihood ratio test (LRT) were used to compare the value of ALBI-CLIP, CLIP and TNM staging systems in predicting survival. Results: A total of 207 patients were included. 153 (73.9%) and 54 (26.1%) patients were classified as Child-Pugh grade A and B, respectively. But according to ALBI grade, 57 (27.5%), 136 (65.7%) and 14 (6.8%) of them were correspondingly divided into Grade 1, 2 and 3. Comparisons of ROC curves showed that ALBI-CLIP and CLIP had similar areas under the curve, both of which were larger than that of TNM system in predicting 3-month, 6-month, 1-year and 2-year survival. LRT indicated that both ALBI-CLIP and CLIP had larger χ2 values and smaller values of Akaike information criterion (AIC), compared with TNM system (χ2 = 29.771, 29.479, 9.105; AIC = 858.215, 858.069, 879.410 for ALBI-CLIP, CLIP and TNM, respectively). Conclusions: Our current study suggested that modified CLIP score with albumin-bilirubin grade retained prognostic value in HBV-related HCC treated with TACE therapy.

Myeloid deprived suppressive cell to mediate the prognostic value of neutrophil to hemoglobin ratio for hepatocellular carcinoma patients receiving transcatheter arterial chemoembolization.

2016 ◽  
Vol 34 (4_suppl) ◽  
pp. 292-292
Author(s):  
Xing Li ◽  
Quan Yang ◽  
Zhi-Huan Lin ◽  
Yingfen Hong ◽  
Yu-Feng Liu ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Prognostic Value ◽  
Mononuclear Cells ◽  
Transcatheter Arterial Chemoembolization ◽  
Statistical Significance ◽  
Score System ◽  
Neutrophil Lymphocyte Ratio ◽  
Cell Counts ◽  
Staging Systems ◽  
Arterial Chemoembolization

292 Background: The prognosis of hepatocellular carcinoma (HCC) patients receiving transcatheter arterial chemoembolization (TACE) is far from being identified. The present study aimed to assess role of blood cell counts, routine liver function tests and neutrophil to hemoglobin ratio (NHR) in predicting the progression-free survival (PFS) of these patients. Methods: A total of 243 HCC patients receiving TACE were analyzed retrospectively. Results: Cancer of the Liver Italian Program (CLIP) score system was identified to be the best score system among current 12 staging systems for this patient subgroup according akaike information criterion (AIC) index and linear trend χ2. Then, the novel prognostic value of parameters was determined by integration into CLIP score system. As a result, NHR were confirmed to an independent predictor for PFS of HCC patients receiving TACE (p = 0.001) with the other parameters, including neutrophil and neutrophil-lymphocyte ratio (NLR), failed to reach statistical significance. Moreover, NHR improved the performance of CLIP by adjusted into it, thus improved the discriminatory ability. Furthermore, NHR were defined value ≤ 0.02 as low level and > 0.02 as high level, according to which patients were dichotomized into two groups. HCC patients receiving TACE with low NHR presented higher 1 year disease control rate (DCR) (50.0% vs 39.35%) and 2 year DCR (45.4% vs 27.0%) compared with patients with high NHR level. Besides, NHR level was associated with prognostic factors such as portal vein thrombosis and distant metastasis. Furthermore, in order to determine the mechanism of predictive value of AHR, we tested the proportion of myeloid deprived suppressive cell (MDSC) in peripheral blood mononuclear cells (PBMC) of 43 HCC patients. It was revealed that MDSC was positively correlated with neutrophil (P< 0.05). Since MDSC was cancer promoter, it might be the mechanism of the prognostic value of NHR. Conclusions: The present study firstly identified NHR as an independent prognostic factor in HCC patients receiving TACE. The positive correlation of MDSC and neutrophil might be the latent mechanism.

scholarly journals Redefining Hepatocellular Carcinoma Staging Systems Based on the Bile Duct Invasion Status: A Multicenter Study

2021 ◽  
Vol 11 ◽  
Author(s):  
Qizhen Huang ◽  
Yufeng Chen ◽  
Kongying Lin ◽  
Chuandong Sun ◽  
Shuguo Zheng ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Bile Duct ◽  
Liver Cancer ◽  
Prognostic Value ◽  
Predictive Performance ◽  
Proportional Hazard ◽  
Cox Proportional Hazard ◽  
Staging Systems ◽  
Bile Duct Invasion ◽  
Cox Proportional Hazard Regression

Background and AimsThe prognostic value of bile duct invasion (BDI) remains controversial. We aimed to investigate the prognostic value of BDI and the stage of BDI in different staging systems.MethodsPatients with hepatocellular carcinoma (HCC) from nine hepatobiliary medical centers who underwent R0 resection were included. Overall survival (OS) was assessed using the Kaplan–Meier method and tested using the log-rank test. The prognostic effect of BDI was analyzed using univariate and multivariate Cox proportional hazard regression analyses. The predictive performance of these models was evaluated using the concordance index and time-dependent receiver operating characteristic curve (tdAUC).ResultsOf 1021 patients with HCC, 177 had BDI. OS was worse in the HCC with BDI group than in the HCC without BDI group (p&lt;0.001); multivariate analysis identified BDI as an independent risk factor for OS. After adjustment for interference of confounding factors using the Cox proportional hazard regression model, HCC with BDI and without macrovascular invasion was classified as Barcelona Clinic Liver Cancer (BCLC) B, eighth edition American Joint Committee on Cancer (AJCC) IIIA, and China Liver Cancer (CNLC) IIb, respectively, whereas HCC with BDI and macrovascular was classified as BCLC C, AJCC IIIB, and CNLC IIIA, respectively. C-indexes and tdAUCs of the adjusted staging systems were superior to those of the corresponding current staging systems.ConclusionWe constructed adjusted staging systems with the BDI status, improved their predictive performance and facilitate clinical use.

scholarly journals Prognostic Value of Microvascular Invasion in Eight Existing Staging Systems for Hepatocellular Carcinoma: A Bi-Centeric Retrospective Cohort Study

2021 ◽  
Vol 11 ◽  
Author(s):  
Yan-Jun Xiang ◽  
Kang Wang ◽  
Yi-Tao Zheng ◽  
Hong-Ming Yu ◽  
Yu-Qiang Cheng ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Cancer ◽  
Prognostic Value ◽  
Staging System ◽  
Microvascular Invasion ◽  
Survival Outcomes ◽  
Entire Cohort ◽  
Significant Survival ◽  
Staging Systems ◽  
Survival Differences

BackgroundMicrovascular invasion (MVI) is a significant risk factor affecting survival outcomes of patients after R0 liver resection (LR) for hepatocellular carcinoma (HCC). However, whether the existing staging systems of hepatocellular carcinoma can distinguish the prognosis of patients with MVI and the prognostic value of MVI in different subtypes of hepatocellular carcinoma remains to be clarified.MethodsA dual-center retrospective data set of 1,198 HCC patients who underwent R0 LR was included in the study between 2014 and 2016. Baseline characteristics and staging information were collected. Homogeneity and modified Akaike information criterion (AICc) were compared between each system. And the prognostic significance of MVI for overall survival (OS) was studied in each subgroup.ResultsIn the entire cohort, there were no significant survival differences between Cancer of the Liver Italian Program (CLIP) score 2 and 3 (p = 0.441), and between Taipei Integrated Scoring System (TIS) score 3 and 4 (p = 0.135). In the MVI cohort, there were no significant survival differences between Barcelona Clinic Liver Cancer stages B and C (p=0.161), CLIP scores 2 and 3 (p = 0.083), TIS scores 0 and 1 (p = 0.227), TIS scores 2 and 3 (p =0.794), Tokyo scores 3 and 4 (p=0.353), and American Joint Committee on Cancer Tumor-Node-Metastasis 7th stage I and II (p=0.151). Among the eight commonly used HCC staging systems, the Hong Kong Liver Cancer (HKLC) staging system showed the highest homogeneity and the lowest AICc value in both the entire cohort and MVI cohort. In each subgroup of the staging systems, MVI generally exhibited poor survival outcomes.ConclusionsThe HKLC staging system was the most accurate model for discriminating the prognosis of MVI patients, among the eight staging systems. Meanwhile, our findings suggest that MVI may be needed to be incorporated into the current HCC staging systems as one of the grading criteria.

Platelet-to-hemoglobin ratio to predict progression-free survival for patients with locally advanced hepatocellular carcinoma.

2017 ◽  
Vol 35 (4_suppl) ◽  
pp. 463-463 ◽  
Author(s):  
Xing Li ◽  
Yan-Fang Xing ◽  
Zhi-Huan Lin ◽  
Ying-fen Hong ◽  
Dong-hao Wu ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Prognostic Factors ◽  
Prognostic Value ◽  
Locally Advanced ◽  
Progression Free Survival ◽  
Advanced Hepatocellular Carcinoma ◽  
Free Survival ◽  
Advanced Hcc ◽  
Staging Systems ◽  
Score Systems

463 Background: The prognosis of locally advanced hepatocellular carcinoma (HCC) patients is far from being identified which makes the treatment decision controversial. The present study aimed to assess role of blood cell counts, routine liver function tests in predicting the progression-free survival (PFS) of these patients. Methods: A total of 243 HCC patients staged Barcelona Clinic Liver Cancer (BCLC) B or C were analyzed retrospectively. The current staging systems of HCC were investigated about their performance on predicting PFS. And then, the novel prognostic factors were evaluated by integrating in to the best staging systems which was used to determine their independent prognostic value. Results: Cancer of the liver Italian program (CLIP) score system and advanced liver cancer prognostic system (ALCPS) stages were indentified to be testing systems with best akaike information criterion (AIC) index and linear trend χ2 among all the current 12 staging systems for this patient subgroup. Then, the prognostic value of novel parameters was assessed by integration into CLIP and ALCPS score systems. Platelet-to-Hemoglobin Ratio (PHR) were confirmed to an independent predictor for PFS of locally advanced HCC patients when integrated into CLIP and ALCPS score systems ( p= 0.026 and 0.009, respectively) with the other parameters, including platelet and hemoglobin, failed to reach statistical significance. Moreover, PHR improved the performance of CLIP and ALCPS score systems by adjusted into it, which improved their discriminatory ability. Furthermore, PHR were designated ≤ 1.26 as low level and > 1.26 as high level, according to which HCC patients were dichotomized into two groups. Locally advanced HCC patients with low PHR presented better 1 year disease progress rate (24.0% vs 41%) and overall survival (62.5% vs 38.8%) compared with patients with high PHR level. Besides, PHR level was associated with prognostic factors such as international normalized ratio, presence of ascites, serum albumin, serum α-fetoprotein, total bilirubin and portal vein thrombosis. Conclusions: The present study firstly indentified PHR as an independent prognostic factor in locally advanced HCC patients.

Prognostic value of serum osteopontin in hepatocellular carcinoma patients treated with transarterial chemoembolization

2009 ◽  
Vol 15 (3) ◽  
pp. 320 ◽  
Author(s):  
Sung Hoon Kim ◽  
Young-Hwa Chung ◽  
Soo Hyun Yang ◽  
Jeong A Kim ◽  
Myoung Kuk Jang ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Transarterial Chemoembolization ◽  
Prognostic Value

scholarly journals The effect of chronic viral hepatitis on prognostic value of inflammatory biomarkers in hepatocellular carcinoma

2021 ◽  
Author(s):  
Cortlandt M. Sellers ◽  
Johannes Uhlig ◽  
Johannes M. Ludwig ◽  
Jeffrey S. Pollak ◽  
Tamar H. Taddei ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Viral Hepatitis ◽  
Prognostic Value ◽  
Chronic Viral Hepatitis ◽  
Inflammatory Biomarkers

scholarly journals In Silico Identification of Contradictory Role of ADAMTS5 in Hepatocellular Carcinoma

2021 ◽  
Vol 20 ◽  
pp. 153303382098682
Author(s):  
Zhipeng Zhu ◽  
Jiuhua Xu ◽  
Xiaofang Wu ◽  
Sihao Lin ◽  
Lulu Li ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Subgroup Analysis ◽  
Prognostic Value ◽  
Molecular Mechanisms ◽  
Enrichment Analysis ◽  
Gene Set Enrichment Analysis ◽  
Clinicopathological Parameters ◽  
Free Survival ◽  
Cox Regression Analysis ◽  
The Impact

Background: ADAMTS5 has different roles in multiple types of cancers and participates in various molecular mechanisms. However, the prognostic value of ADAMTS5 in patients with hepatocellular carcinoma (HCC) still remains unclear. We carried the study to evaluate the prognostic value and identified underlying molecular mechanisms in HCC. Methods: Firstly, the association of ADAMTS5 expression and clinicopathological parameters was evaluated by in GSE14520. Next, ADAMTS5 expression in HCC was performed using GSE14520, GSE36376, GSE76427 and The Cancer Genome Atlas (TCGA) profile. Furthermore, Kaplan-Meier analysis, Univariate and Multivariate Cox regression analysis, subgroup analysis was performed to evaluate the prognostic value of ADAMTS5 in HCC. Finally, GO enrichment analysis, gene set enrichment analysis (GSEA) and weighted gene co-expression network analysis (WGCNA) were performed to revealed underlying molecular mechanisms. Result: The expression of ADAMTS5 was positively correlated with the development of HCC. Next, high ADAMTS5 expression was significantly associated with poorer survival (all P < 0.05) and the impact of ADAMTS5 on all overall survival (OS), disease-free survival (DFS), relapse-free survival (RFS), disease specific survival (DSS) and progression free interval (PFI) was specific for HCC among other 29 cancer types. Subgroup analysis showed that ADAMTS5 overexpression was significantly associated with poorer OS in patients with HCC. Finally, ADAMTS5 might participate in the status conversion from metabolic-dominant to extracellular matrix-dominant, and the activation of ECM-related biological process might contribute to high higher mortality risk for patients with HCC. Conclusion: ADAMTS5 may play an important role in the progression of HCC, and may be considered as a novel and effective biomarker for predicting prognosis for patients with HCC.

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