Stephen L Chan1, Frankie Mo1, Philip Johnson2, Leung Li1, Nelson Tang3, Herbert Loong1, Anthony W H Chan4, Jane Koh1, Anthony T C Chan1, Winnie Yeo1. 1. State Key Laboratory in Oncology in South China, Sir YK Pao Center for Cancer, Department of Clinical Oncology, Hong Kong Cancer Institute and Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, Hong Kong. 2. Department of Molecular and Clinical Cancer Medicine, Institute of Translational Medicine, University of Liverpool, Liverpool, UK. 3. Department of Chemical Pathology, The Chinese University of Hong Kong, Hong Kong, Hong Kong. 4. Department of Anatomical and Cellular Pathology, State Key Laboratory in Oncology in South China, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, Hong Kong.
Abstract
BACKGROUND AND AIMS: The BALAD score is developed to provide an objective determination of prognosis for hepatocellular carcinoma (HCC) by incorporating five serum markers, namely albumin, bilirubin, alpha-fetoprotein (AFP), agglutinin-reactive alpha-fetoprotein (AFP-L3), and des-γ-carboxy prothrombin. We aim to study the applicability of BALAD score and prognostication of the three tumor markers in hepatitis B virus-related HCC. METHODS: Patients with newly diagnosed HCC were prospectively enrolled. All of the baseline characteristics and serum albumin and bilirubin level were documented at baseline. The levels of the three tumor markers (AFP, AFP-L3, and des-γ-carboxy prothrombin) were determined in archival serum samples. Patients were followed up for survivals according to local practice. The prognostic performances of the three markers and BALAD score were studied in association with overall survival (OS). RESULTS: A total of 198 patients with hepatitis B-related HCC were recruited. AFP and AFP-L3 levels were independent prognostic factors. The number of elevated tumor markers was also predictive of worse OS. BALAD score could stratify the cohort into different patient groups with distinct median OS. The median OS of BALAD score of 0, 1, 2, 3, and 4 was not reached, 26.6, 8.3, 2.6, and 1.9 months, respectively (P < 0.0001). BALAD score could further stratify outcomes in each Barcelona Clinic Liver Cancer (BCLC) subgroup. In particular, BALAD score of 3-4 had median OS of 2.6 months only in BCLC stage C patients. CONCLUSION: BALAD score is applicable in the population of hepatitis B virus-related HCC. The combined use of BALAD score and BCLC staging system could help identify more suitable candidates for clinical trial.
BACKGROUND AND AIMS: The BALAD score is developed to provide an objective determination of prognosis for hepatocellular carcinoma (HCC) by incorporating five serum markers, namely albumin, bilirubin, alpha-fetoprotein (AFP), agglutinin-reactive alpha-fetoprotein (AFP-L3), and des-γ-carboxy prothrombin. We aim to study the applicability of BALAD score and prognostication of the three tumor markers in hepatitis B virus-related HCC. METHODS:Patients with newly diagnosed HCC were prospectively enrolled. All of the baseline characteristics and serum albumin and bilirubin level were documented at baseline. The levels of the three tumor markers (AFP, AFP-L3, and des-γ-carboxy prothrombin) were determined in archival serum samples. Patients were followed up for survivals according to local practice. The prognostic performances of the three markers and BALAD score were studied in association with overall survival (OS). RESULTS: A total of 198 patients with hepatitis B-related HCC were recruited. AFP and AFP-L3 levels were independent prognostic factors. The number of elevated tumor markers was also predictive of worse OS. BALAD score could stratify the cohort into different patient groups with distinct median OS. The median OS of BALAD score of 0, 1, 2, 3, and 4 was not reached, 26.6, 8.3, 2.6, and 1.9 months, respectively (P < 0.0001). BALAD score could further stratify outcomes in each Barcelona Clinic Liver Cancer (BCLC) subgroup. In particular, BALAD score of 3-4 had median OS of 2.6 months only in BCLC stage C patients. CONCLUSION: BALAD score is applicable in the population of hepatitis B virus-related HCC. The combined use of BALAD score and BCLC staging system could help identify more suitable candidates for clinical trial.
Authors: Sophia Heinrich; Martin Sprinzl; Irene Schmidtmann; Elena Heil; Sandra Koch; Carolin Czauderna; Bernd Heinrich; Laurence Philippe P Diggs; Marcus-Alexander Wörns; Roman Kloeckner; Peter R Galle; Jens U Marquardt; Arndt Weinmann Journal: United European Gastroenterol J Date: 2020-01-29 Impact factor: 4.623
Authors: Nicha Wongjarupong; Gabriela M Negron-Ocasio; Roongruedee Chaiteerakij; Benyam D Addissie; Essa A Mohamed; Kristin C Mara; William S Harmsen; J Paul Theobald; Brian E Peters; Joseph G Balsanek; Melissa M Ward; Nasra H Giama; Sudhakar K Venkatesh; Denise M Harnois; Michael R Charlton; Hiroyuki Yamada; Alicia Algeciras-Schimnich; Melissa R Snyder; Terry M Therneau; Lewis R Roberts Journal: World J Gastroenterol Date: 2018-03-28 Impact factor: 5.742