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Article: Predicting prognosis in hepatocellular carcinoma after curative surgery with common clinicopathologic parameters

TitlePredicting prognosis in hepatocellular carcinoma after curative surgery with common clinicopathologic parameters
Authors
Issue Date2009
PublisherBioMed Central Ltd. The Journal's web site is located at http://www.biomedcentral.com/bmccancer/
Citation
Bmc Cancer, 2009, v. 9 How to Cite?
Abstract
Background: Surgical resection is one important curative treatment for hepatocellular carcinoma (HCC), but the prognosis following surgery differs substantially and such large variation is mainly unexplained. A review of the literature yields a number of clinicopathologic parameters associated with HCC prognosis. However, the results are not consistent due to lack of systemic approach to establish a prediction model incorporating all these parameters. Methods: We conducted a retrospective analysis on the common clinicopathologic parameters from a cohort of 572 ethnic Chinese HCC patients who received curative surgery. The cases were randomly divided into training (n = 272) and validation (n = 300) sets. Each parameter was individually tested and the significant parameters were entered into a linear classifier for model building, and the prediction accuracy was assessed in the validation set. Results: Our findings based on the training set data reveal 6 common clinicopathologic parameters (tumor size, number of tumor nodules, tumor stage, venous infiltration status, and serum α-fetoprotein and total albumin levels) that were significantly associated with the overall HCC survival and disease-free survival (time to recurrence). We next built a linear classifier model by multivariate Cox regression to predict prognostic outcomes of HCC patients after curative surgery This analysis detected a considerable fraction of variance in HCC prognosis and the area under the ROC curve was about 70%. We further evaluated the model using two other protocols; leave-one-out procedure (n = 264) and independent validation (n = 300). Both were found to have excellent prediction power. The predicted score could separate patients into distinct groups with respect to survival (p-value = 1.8e-12) and disease free survival (p-value = 3.2e-7). Conclusion: This described model will provide valuable guidance on prognosis after curative surgery for HCC in clinical practice. The adaptive nature allows easy accommodation for future new biomarker inputs, and it may serve as the foundation for future modeling and prediction for HCC prognosis after surgical treatment. © 2009 Hao et al; licensee BioMed Central Ltd.
Persistent Identifierhttp://hdl.handle.net/10722/88627
ISSN
2013 Impact Factor: 3.319
2013 SCImago Journal Rankings: 1.686
PubMed Central ID
ISI Accession Number ID
Funding AgencyGrant Number
Research Grants Council of Hong Kong and Innovation and Technology Fund of the Hong Kong Government
Funding Information:

The work was supported by Research Grants Council of Hong Kong and Innovation and Technology Fund of the Hong Kong Government to J. M. L. We would like to thank for the technical supports from Ashley Wong and Kit-Yuk Mak of the Queen Mary Hospital. IOL Ng is a Loke Yew Professor in Pathology.

References

 

DC FieldValueLanguage
dc.contributor.authorHao, Ken_HK
dc.contributor.authorLuk, JMen_HK
dc.contributor.authorLee, NPYen_HK
dc.contributor.authorMao, Men_HK
dc.contributor.authorZhang, Cen_HK
dc.contributor.authorFerguson, MDen_HK
dc.contributor.authorLamb, Jen_HK
dc.contributor.authorDai, Hen_HK
dc.contributor.authorNg, IOen_HK
dc.contributor.authorSham, PCen_HK
dc.contributor.authorPoon, RTPen_HK
dc.date.accessioned2010-09-06T09:45:52Z-
dc.date.available2010-09-06T09:45:52Z-
dc.date.issued2009en_HK
dc.identifier.citationBmc Cancer, 2009, v. 9en_HK
dc.identifier.issn1471-2407en_HK
dc.identifier.urihttp://hdl.handle.net/10722/88627-
dc.description.abstractBackground: Surgical resection is one important curative treatment for hepatocellular carcinoma (HCC), but the prognosis following surgery differs substantially and such large variation is mainly unexplained. A review of the literature yields a number of clinicopathologic parameters associated with HCC prognosis. However, the results are not consistent due to lack of systemic approach to establish a prediction model incorporating all these parameters. Methods: We conducted a retrospective analysis on the common clinicopathologic parameters from a cohort of 572 ethnic Chinese HCC patients who received curative surgery. The cases were randomly divided into training (n = 272) and validation (n = 300) sets. Each parameter was individually tested and the significant parameters were entered into a linear classifier for model building, and the prediction accuracy was assessed in the validation set. Results: Our findings based on the training set data reveal 6 common clinicopathologic parameters (tumor size, number of tumor nodules, tumor stage, venous infiltration status, and serum α-fetoprotein and total albumin levels) that were significantly associated with the overall HCC survival and disease-free survival (time to recurrence). We next built a linear classifier model by multivariate Cox regression to predict prognostic outcomes of HCC patients after curative surgery This analysis detected a considerable fraction of variance in HCC prognosis and the area under the ROC curve was about 70%. We further evaluated the model using two other protocols; leave-one-out procedure (n = 264) and independent validation (n = 300). Both were found to have excellent prediction power. The predicted score could separate patients into distinct groups with respect to survival (p-value = 1.8e-12) and disease free survival (p-value = 3.2e-7). Conclusion: This described model will provide valuable guidance on prognosis after curative surgery for HCC in clinical practice. The adaptive nature allows easy accommodation for future new biomarker inputs, and it may serve as the foundation for future modeling and prediction for HCC prognosis after surgical treatment. © 2009 Hao et al; licensee BioMed Central Ltd.en_HK
dc.languageengen_HK
dc.publisherBioMed Central Ltd. The Journal's web site is located at http://www.biomedcentral.com/bmccancer/en_HK
dc.relation.ispartofBMC Canceren_HK
dc.rightsCreative Commons: Attribution 3.0 Hong Kong License-
dc.subject.meshArea Under Curve-
dc.subject.meshCarcinoma, Hepatocellular - mortality - pathology - surgery-
dc.subject.meshDisease-Free Survival-
dc.subject.meshHumans-
dc.subject.meshLiver Neoplasms - mortality - pathology - surgery-
dc.titlePredicting prognosis in hepatocellular carcinoma after curative surgery with common clinicopathologic parametersen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=1471-2407&volume=9 article no. 389&spage=&epage=&date=2009&atitle=Predicting+prognosis+in+hepatocellular+carcinoma+after+curative+surgery+with+common+clinicopathologic+parametersen_HK
dc.identifier.emailLuk, JM: jmluk@hkucc.hku.hken_HK
dc.identifier.emailLee, NPY: nikkilee@hku.hken_HK
dc.identifier.emailNg, IO: iolng@hku.hken_HK
dc.identifier.emailSham, PC: pcsham@hku.hken_HK
dc.identifier.emailPoon, RTP: poontp@hku.hken_HK
dc.identifier.authorityLuk, JM=rp00349en_HK
dc.identifier.authorityLee, NPY=rp00263en_HK
dc.identifier.authorityNg, IO=rp00335en_HK
dc.identifier.authoritySham, PC=rp00459en_HK
dc.identifier.authorityPoon, RTP=rp00446en_HK
dc.description.naturepublished_or_final_version-
dc.identifier.doi10.1186/1471-2407-9-389en_HK
dc.identifier.pmid19886989-
dc.identifier.pmcidPMC2785835-
dc.identifier.scopuseid_2-s2.0-71549154370en_HK
dc.identifier.hkuros168602en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-71549154370&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume9en_HK
dc.identifier.isiWOS:000272337500001-
dc.publisher.placeUnited Kingdomen_HK
dc.identifier.scopusauthoridHao, K=34770116300en_HK
dc.identifier.scopusauthoridLuk, JM=7006777791en_HK
dc.identifier.scopusauthoridLee, NPY=7402722690en_HK
dc.identifier.scopusauthoridMao, M=7102960472en_HK
dc.identifier.scopusauthoridZhang, C=7405492903en_HK
dc.identifier.scopusauthoridFerguson, MD=35208305500en_HK
dc.identifier.scopusauthoridLamb, J=7201524642en_HK
dc.identifier.scopusauthoridDai, H=7402206916en_HK
dc.identifier.scopusauthoridNg, IO=7102753722en_HK
dc.identifier.scopusauthoridSham, PC=34573429300en_HK
dc.identifier.scopusauthoridPoon, RTP=7103097223en_HK
dc.identifier.citeulike6075470-

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