A novel and validated prognostic index in hepatocellular carcinoma: The inflammation based index (IBI)

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Title: A novel and validated prognostic index in hepatocellular carcinoma: The inflammation based index (IBI)
Authors: Pinato, DJ
Stebbing, J
Ishizuka, M
Khan, SA
Wasan, HS
North, BV
Kubota, K
Sharma, R
Item Type: Journal Article
Abstract: Background & Aims Outcome prediction is uniquely different in hepatocellular carcinoma (HCC) as the progressive functional impairment of the liver impacts patient survival independently of tumour stage. As chronic inflammation is associated with the pathogenesis of HCC, we explored the prognostic impact of a panel of inflammatory based scores, including the modified Glasgow Prognostic Score (mGPS), neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR), in independent cohorts. Methods Inflammatory markers, Barcelona Clinic Liver Cancer (BCLC) and Cancer of the Liver Italian Program (CLIP) scores were studied in a training set of 112 patients with predominantly unresectable HCC (75%). Independent predictors of survival identified in multivariate analysis were validated in an independent cohort of 466 patients with an overall lower tumour burden (BCLC-A, 56%). Results In both training and validation sets, mGPS and CLIP scores emerged as independent predictors of overall survival. The predictive accuracy of the combined mGPS and CLIP score (c score 0.7, 95% CI 0.6–0.8) appeared superior to that of the CLIP score alone (c score 0.6, 95% CI 0.5–0.7). Conclusions Systemic inflammation as measured by the mGPS, independently predicts overall survival in HCC. We have validated a novel, easy to use inflammatory score that can be used to stratify individuals. These data enable formulation of a new prognostic system, the inflammation based index in HCC (IBI). Further validation of the IBI considering treatment allocation and survival is warranted in an independent patient cohort.
Issue Date: 22-Jun-2012
Date of Acceptance: 14-Jun-2012
URI: http://hdl.handle.net/10044/1/41474
DOI: https://dx.doi.org/10.1016/j.jhep.2012.06.022
ISSN: 1600-0641
Publisher: Elsevier
Start Page: 1013
End Page: 1020
Journal / Book Title: Journal of Hepatology
Volume: 57
Issue: 5
Copyright Statement: © 2012, Elsevier. Licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International http://creativecommons.org/licenses/by-nc-nd/4.0/
Keywords: Science & Technology
Life Sciences & Biomedicine
Gastroenterology & Hepatology
1103 Clinical Sciences
Publication Status: Published
Appears in Collections:Division of Surgery
Division of Cancer
Faculty of Medicine

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