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Article: A new prognostic score system in patients with advanced hepatocellular carcinoma not amendable to locoregional therapy: Implication for patient selection in systemic therapy trials

TitleA new prognostic score system in patients with advanced hepatocellular carcinoma not amendable to locoregional therapy: Implication for patient selection in systemic therapy trials
Authors
Keywords3-month overall survival
Advanced hepatocellular carcinoma
Advanced Liver Cancer Prognostic System
Prognostic score system
Issue Date2008
PublisherJohn Wiley & Sons, Inc. The Journal's web site is located at http://www3.interscience.wiley.com/cgi-bin/jhome/28741
Citation
Cancer, 2008, v. 113 n. 10, p. 2742-2751 How to Cite?
AbstractBACKGROUND. Advanced hepatocellular carcinoma (HCC) patients who are not candidates for surgery or locoregional therapy are the focus of clinical trials of systemic therapy, as their overall prognosis remains poor. However, the current prognostic systems cannot reliably select appropriate candidates for systemic therapy trials based on the probability of 3-month survival. In this study, the authors constructed a new prognostic score system, the Advanced Liver Cancer Prognostic System (ALCPS), which can objectively predict the probability of 3-month survival. METHODS. Between 1990 and 2005, 1470 patients with advanced HCC who were not amendable to surgery or locoregional therapy were included in the analysis. The prognostic score system was developed from the multivariate Cox model through a point system and validated in an independent set. Okuda staging and Cancer of the Liver Italian Program (CLIP) score were also applied to the validation set to compare their predictive accuracy. RESULTS. The ALCPS was based on 11 prognostic factors with different weights: ascites, abdominal pain, weight loss, Child-Pugh grade, alkaline phosphatase, total bilirubin, alpha-fetal protein, urea, portal vein thrombosis, tumor size, and presence of lung metastases. It stratified patients in both training and validation sets to different prognostic groups with significant difference in 3-month overall survival (P <.0001). By using the patients in the validation set with known 3-month survival status, the ALCPS showed significantly better predictive power (area under the curve [AUC], 0.77) than Okuda score (AUC, 0.66; P <.001) and CLIP score (AUC, 0.71; P =.002). CONCLUSIONS. The new prognostic system can objectively help the clinicians to select appropriate candidates for evaluation of treatment efficacy in systemic therapy trials for advanced HCC. © 2008 American Cancer Society.
Persistent Identifierhttp://hdl.handle.net/10722/60435
ISSN
2015 Impact Factor: 5.649
2015 SCImago Journal Rankings: 3.188
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorYau, Ten_HK
dc.contributor.authorTzy, JYen_HK
dc.contributor.authorChan, Pen_HK
dc.contributor.authorNg, Ken_HK
dc.contributor.authorSheung, TFen_HK
dc.contributor.authorPoon, RTPen_HK
dc.date.accessioned2010-05-31T04:10:44Z-
dc.date.available2010-05-31T04:10:44Z-
dc.date.issued2008en_HK
dc.identifier.citationCancer, 2008, v. 113 n. 10, p. 2742-2751en_HK
dc.identifier.issn0008-543Xen_HK
dc.identifier.urihttp://hdl.handle.net/10722/60435-
dc.description.abstractBACKGROUND. Advanced hepatocellular carcinoma (HCC) patients who are not candidates for surgery or locoregional therapy are the focus of clinical trials of systemic therapy, as their overall prognosis remains poor. However, the current prognostic systems cannot reliably select appropriate candidates for systemic therapy trials based on the probability of 3-month survival. In this study, the authors constructed a new prognostic score system, the Advanced Liver Cancer Prognostic System (ALCPS), which can objectively predict the probability of 3-month survival. METHODS. Between 1990 and 2005, 1470 patients with advanced HCC who were not amendable to surgery or locoregional therapy were included in the analysis. The prognostic score system was developed from the multivariate Cox model through a point system and validated in an independent set. Okuda staging and Cancer of the Liver Italian Program (CLIP) score were also applied to the validation set to compare their predictive accuracy. RESULTS. The ALCPS was based on 11 prognostic factors with different weights: ascites, abdominal pain, weight loss, Child-Pugh grade, alkaline phosphatase, total bilirubin, alpha-fetal protein, urea, portal vein thrombosis, tumor size, and presence of lung metastases. It stratified patients in both training and validation sets to different prognostic groups with significant difference in 3-month overall survival (P <.0001). By using the patients in the validation set with known 3-month survival status, the ALCPS showed significantly better predictive power (area under the curve [AUC], 0.77) than Okuda score (AUC, 0.66; P <.001) and CLIP score (AUC, 0.71; P =.002). CONCLUSIONS. The new prognostic system can objectively help the clinicians to select appropriate candidates for evaluation of treatment efficacy in systemic therapy trials for advanced HCC. © 2008 American Cancer Society.en_HK
dc.languageengen_HK
dc.publisherJohn Wiley & Sons, Inc. The Journal's web site is located at http://www3.interscience.wiley.com/cgi-bin/jhome/28741en_HK
dc.relation.ispartofCanceren_HK
dc.rightsCancer. Copyright © John Wiley & Sons, Inc.en_HK
dc.subject3-month overall survivalen_HK
dc.subjectAdvanced hepatocellular carcinomaen_HK
dc.subjectAdvanced Liver Cancer Prognostic Systemen_HK
dc.subjectPrognostic score systemen_HK
dc.titleA new prognostic score system in patients with advanced hepatocellular carcinoma not amendable to locoregional therapy: Implication for patient selection in systemic therapy trialsen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0008-543X&volume=113&issue=10&spage=2742&epage=2751&date=2008&atitle=A+new+prognostic+score+system+in+patients+with+advanced+hepatocellular+carcinoma+not+amendable+to+locoregional+therapy:+implication+for+patient+selection+in+systemic+therapy+trialsen_HK
dc.identifier.emailYau, T: tyaucc@hku.hken_HK
dc.identifier.emailTzy, JY: tjyao@hkucc.hku.hken_HK
dc.identifier.emailPoon, RTP: poontp@hku.hken_HK
dc.identifier.authorityYau, T=rp01466en_HK
dc.identifier.authorityTzy, JY=rp00284en_HK
dc.identifier.authorityPoon, RTP=rp00446en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1002/cncr.23878en_HK
dc.identifier.pmid18853421-
dc.identifier.scopuseid_2-s2.0-55849100032en_HK
dc.identifier.hkuros153737en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-55849100032&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume113en_HK
dc.identifier.issue10en_HK
dc.identifier.spage2742en_HK
dc.identifier.epage2751en_HK
dc.identifier.eissn1097-0142-
dc.identifier.isiWOS:000260914400016-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridYau, T=23391533100en_HK
dc.identifier.scopusauthoridTzy, JY=7401886444en_HK
dc.identifier.scopusauthoridChan, P=7403497715en_HK
dc.identifier.scopusauthoridNg, K=35248894000en_HK
dc.identifier.scopusauthoridSheung, TF=6506234707en_HK
dc.identifier.scopusauthoridPoon, RTP=7103097223en_HK

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