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The Kings Score refines prognostic prediction in hepatocellular carcinoma: a novel application

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Title: The Kings Score refines prognostic prediction in hepatocellular carcinoma: a novel application
Authors: Pinato, DJ
Karamanakos, G
Ishizuka, M
Smirne, C
Pirisi, M
Kubota, K
Sharma, R
Item Type: Journal Article
Abstract: Background & Aims: There are a number of prognostic scores in hepatocellular carcinoma (HCC), none of which is optimalin predicting overall survival (OS) in the individual patient, particularly in intermediate stage disease, where patients are notsurgically treatable but may qualify for a wide range of palliative interventions. We evaluated the prognostic role of a bio-chemical algorithm, the Kings Score (KS), in the palliative setting of care.Methods: We used the algorithm [age x AST xINR]/platelet count to derive the KS. Full clinical data including Barcelona Clinic Liver Cancer (BCLC) stage were studied in atraining set of 97 patients from the UK. Independent predictors of survival identified in multivariate analysis were validatedin an independent cohort of 766 patients from Japan and Italy.Results: In both training and validation sets, KS was con-firmed as an independent predictor of OS (P < 0.01). Ad-hoc subgroup analysis revealed the KS to be prognostic in the palli-ative setting, being able to subclassify patients presenting with intermediate and advanced disease according to BCLCcriteria (P < 0.001).Conclusion: The KS integrates into the BCLC system to improve prognostic substratification in the palli-ative setting of care. The KS may help reducing disease heterogeneity and refine treatment allocation in intermediate-advanced HCC.
Issue Date: 11-May-2015
Date of Acceptance: 20-Mar-2015
URI: http://hdl.handle.net/10044/1/48971
DOI: https://dx.doi.org/10.1111/liv.12841
ISSN: 1478-3223
Publisher: Wiley
Start Page: 2458
End Page: 2465
Journal / Book Title: Liver International
Volume: 35
Issue: 11
Copyright Statement: © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd. This is the accepted version of the following article: Pinato, David J. and Karamanakos, Georgios and Ishizuka, Mitsuru and Smirne, Carlo and Pirisi, Mario and Kubota, Keiichi and Sharma, Rohini. The Kings Score refines prognostic prediction in hepatocellular carcinoma: a novel application. Liver Int. 2015; 35: 2458–2465, which has been published in final form at https://dx.doi.org/10.1111/liv.12841
Keywords: Science & Technology
Life Sciences & Biomedicine
Gastroenterology & Hepatology
aspartate aminotransferase
hepatocellular carcinoma
international normalized ratio
Kings Score
platelet count
prognosis
CHRONIC HEPATITIS-C
VENOUS-PRESSURE GRADIENT
TRANSARTERIAL CHEMOEMBOLIZATION
LIVER-TRANSPLANTATION
CIRRHOSIS
SURVIVAL
INDEX
RESECTION
CANCER
Adult
Aged
Aged, 80 and over
Algorithms
Carcinoma, Hepatocellular
Female
Humans
Italy
Japan
Kaplan-Meier Estimate
Liver Neoplasms
Male
Middle Aged
Multivariate Analysis
Neoplasm Staging
Prognosis
Proportional Hazards Models
Retrospective Studies
Severity of Illness Index
Young Adult
1103 Clinical Sciences
Publication Status: Published
Appears in Collections:Division of Surgery
Division of Cancer
Faculty of Medicine



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