Oncotarget

Research Papers:

Validation of an IGF-CTP scoring system for assessing hepatic reserve in egyptian patients with hepatocellular carcinoma

Reham Abdel-Wahab, Samir Shehata, Manal M. Hassan, Lianchun Xiao, Ju-Seog Lee, Sheree Cheung, Hoda H. Essa, Hesham M. Hassabo, Ahmed S. Shalaby, Eman Mosad, Kanwal Raghav, Asif Rashid, Robert A. Wolff, Jeffrey S. Morris, Hesham M. Amin and Ahmed O. Kaseb _

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Oncotarget. 2015; 6:21193-21207. https://doi.org/10.18632/oncotarget.4176

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Abstract

Reham Abdel-Wahab1,6, Samir Shehata6, Manal M. Hassan1, Lianchun Xiao2, Ju-Seog Lee3, Sheree Cheung1, Hoda H. Essa6, Hesham M. Hassabo1, Ahmed S. Shalaby1, Eman Mosad7, Kanwal Raghav1, Asif Rashid4, Robert A. Wolff1, Jeffrey S. Morris2, Hesham M. Amin5,8 and Ahmed O. Kaseb1

1 Department of Gastrointestinal Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA

2 Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA

3 Department of Systems Biology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA

4 Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA

5 Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA

6 Department of Clinical Oncology, Assiut University, Egypt

7 Department of Pathology, Assiut University, Egypt

8 Graduate School of Biomedical Sciences, Houston, Texas, USA

Correspondence to:

Ahmed O. Kaseb, email:

Keywords: IGF-1, Child-Pugh, validation, liver reserve, hepatocellular carcinoma

Received: March 26, 2015 Accepted: May 01, 2015 Published: May 19, 2015

Abstract

Background

The Child-Turcotte-Pugh score (CTP) is the standard tool for hepatic reserve assessment in hepatocellular carcinoma (HCC). Recently, we reported that integrating plasma insulin-like growth factor-1 (IGF-1) level into the CTP score was associated with better patient risk stratification in two U.S. independent cohorts. Our current study aimed to validate the IGF-CTP score in patients who have different demographics and risk factors.

Patients and Methods

We prospectively recruited 100 Egyptian patients and calculated their IGF-CTP score compared to CTP score. C-index was used to compare the prognostic significance of the two scoring systems. Finally, we compared our results with our U.S. cohorts published data.

Results

IGF-CTP score showed significant better patient stratification compared to CTP score in the international validation cohort. Among CTP class A patients, who usually considered for active treatment and clinical trial enrollment, 32.5% were reclassified as IGF-CTP class B with significantly shorter OS than patients reclassified as class A with hazard ratio [HR] = 6.15, 95% confidence interval [CI] = 2.18 -17.37.

Conclusion

IGF-CTP score showed significantly better patient stratification and survival prediction not only in the U.S. population but also in international validation population, who had different demographics and HCC risk factors.


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