Beom Kyung Kim1,2, Ju Hyun Shim3, Seung Up Kim1,2, Jun Yong Park1,2, Do Young Kim1,2, Sang Hoon Ahn1,2,4, Kang Mo Kim3, Young-Suk Lim3, Kwang-Hyub Han1,2,4, Han Chu Lee3. 1. Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea. 2. Yonsei Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea. 3. Department of Gastroenterology, Asan Liver Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. 4. Brain Korea 21 Project for Medical Science, Seoul, Korea.
Abstract
BACKGROUNDS & AIMS: We aimed to generate and validate a novel risk prediction model for patients with hepatocellular carcinoma (HCC) undergoing transarterial chemoembolization (TACE). METHODS:Patients receiving TACE as the first-line therapy between 2006 and 2009 were selected from the databases of two major tertiary hospitals in Korea. This study population was randomly assigned into training (n = 340) and validation (n = 145) sets. From a multivariate Cox-regression model for overall survival (OS), tumour Size, tumour Number, baseline Alpha-foetoprotein level, Child-Pugh class and Objective radiological Response after the first TACE session were selected and then scored to generate a 10-point risk prediction model (named as "SNACOR" model) in the training set. Thereafter, the prognostic performance was assessed in the validation set. RESULTS: In the training set, the time-dependent areas under receiver-operating characteristic curves (AUROCs) for OS at 1-, 3- and 6-years were 0.756, 0.754 and 0.742 respectively. According to the score of the SNACOR model, patients were stratified into three groups; low- (score 0-2), intermediate- (score 3-6) and high-risk group (score 7-10) respectively. The low-risk group had the longest median OS (49.8 months), followed by intermediate- (30.7 months) and high-risk group (12.4 months) (log-rank test, P < 0.001). Compared with the low-risk group, the intermediate-risk (hazard ratio [HR] 2.13, P < 0.001) and high-risk group (HR 6.17, P < 0.001) retained significant risks of death. Similar results were obtained in the validation set. CONCLUSION: A simple-to-use SNACOR model for patients with HCC treated withTACE might be helpful in appropriate prognostification and guidance for decision of further treatment strategies.
RCT Entities:
BACKGROUNDS & AIMS: We aimed to generate and validate a novel risk prediction model for patients with hepatocellular carcinoma (HCC) undergoing transarterial chemoembolization (TACE). METHODS:Patients receiving TACE as the first-line therapy between 2006 and 2009 were selected from the databases of two major tertiary hospitals in Korea. This study population was randomly assigned into training (n = 340) and validation (n = 145) sets. From a multivariate Cox-regression model for overall survival (OS), tumour Size, tumour Number, baseline Alpha-foetoprotein level, Child-Pugh class and Objective radiological Response after the first TACE session were selected and then scored to generate a 10-point risk prediction model (named as "SNACOR" model) in the training set. Thereafter, the prognostic performance was assessed in the validation set. RESULTS: In the training set, the time-dependent areas under receiver-operating characteristic curves (AUROCs) for OS at 1-, 3- and 6-years were 0.756, 0.754 and 0.742 respectively. According to the score of the SNACOR model, patients were stratified into three groups; low- (score 0-2), intermediate- (score 3-6) and high-risk group (score 7-10) respectively. The low-risk group had the longest median OS (49.8 months), followed by intermediate- (30.7 months) and high-risk group (12.4 months) (log-rank test, P < 0.001). Compared with the low-risk group, the intermediate-risk (hazard ratio [HR] 2.13, P < 0.001) and high-risk group (HR 6.17, P < 0.001) retained significant risks of death. Similar results were obtained in the validation set. CONCLUSION: A simple-to-use SNACOR model for patients with HCC treated with TACE might be helpful in appropriate prognostification and guidance for decision of further treatment strategies.
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