Research Papers:
A novel scoring system predicts adjuvant chemolipiodolization benefit for hepatocellular carcinoma patients after hepatectomy
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Abstract
Li-feng Huang1,*, Xianglei Xing1,*, Dong Wu2,*, Yong Xia1, Jun Li1, Kui Wang3, Zhen-lin Yan1, Xu-ying Wan4, Le-hua Shi1, Tian Yang1, Wan Yee Lau1,5, Meng-chao Wu1,4, Feng Shen1
1Department of Hepatic Surgery IV, The Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai, China
2Department of Hepatic Surgery I, The Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai, China
3Department of Hepatic Surgery II, The Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai, China
4Department of Clinical Database, The Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai, China
5Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
*These authors contributed equally to this work
Correspondence to:
Feng Shen, email: [email protected]
Keywords: hepatocellular carcinoma, liver resection, adjuvant chemolipiodolization, prognosis, scoring system
Received: November 27, 2015 Accepted: March 07, 2016 Published: March 24, 2016
ABSTRACT
Our aim in this study was to develop a prognostic scoring system with which to identify patients most likely to benefit from adjuvant chemolipiodolization (ACL) after liver resection for hepatocellular carcinoma (HCC). Data from 1150 HCC patients who underwent liver resection between 2002 and 2008 at the Eastern Hepatobiliary Surgery Hospital were used to develop the scoring system. Patients were stratified into prognostic subgroups using the new scoring system, and the outcomes of patients who received ACL and those who did not were compared in each subgroup. Using data from 379 patients operated on between 2008 and 2010 for validation, the scoring system had a concordance index (C-index) of 0.75 for predicting post-resectional overall survival (OS). It optimally stratified patients into three prognostic subgroups with scores of 0–5, 6–9 and ≥ 10, having better, medium and worse survival outcomes, respectively. A difference in OS between ACL and non-ACL patients was only detected in the subgroup with scores ≥ 10 (1-, 3-, and 5-year OS rates: 63.9%, 22.6%, and 9.0% vs. 33.8%, 5.6%, and 2.8%, p = 0.001). Our proposed scoring system provides an effective tool for selecting the patients most likely to benefit from ACL.
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