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Validation of the Hepatoma Arterial Embolization Prognostic Score in European and Asian Populations and Proposed Modification

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Title: Validation of the Hepatoma Arterial Embolization Prognostic Score in European and Asian Populations and Proposed Modification
Authors: Pinato, DJ
Arizumi, T
Allara, E
Jang, JW
Smirne, C
Kim, YW
Kudo, M
Pirisi, M
Sharma, R
Item Type: Journal Article
Abstract: Background & Aims: Transarterial chemoembolization (TACE) is used to treat hepatocellular carcinoma (HCC), but it is a challenge to predict patient survival. The hepatic arterial embolization prognostic (HAP) score has been shown to predict which patients will have shorter survival times and should not undergo TACE. We aimed to validate this scoring system in a prospective study of patients in Europe and Asia. Methods: We evaluated the prognostic accuracy of the HAP score in estimating overall survival (OS) of 126 patients with HCC who received TACE in the United Kingdom or Italy (training set) from 2001 through 2013. We also analyzed data from 723 patients treated in Korea and Japan (validation set), including 79 with newly diagnosed HCC, who underwent TACE in Korea or Japan from 2004 through 2013. Response to TACE was determined based on computed tomography analysis. OS was calculated from the time of the first TACE until death or the last follow-up evaluation. Results: OS was associated with hypoalbuminemia, α-fetoprotein level greater than 400 ng/mL, and tumor size greater than 7 cm at diagnosis (P < .01), but not a bilirubin level greater than 17 umol/L (P > .05), in both data sets. The lack of association between OS and bilirubin level was confirmed using receiver operating characteristic analysis. We developed a modified version of the HAP score, based on the level of albumin and α-fetoprotein and tumor size, which predicted OS with increased accuracy in the training and validation cohorts. Conclusions: In a multicenter validation study, we developed a modified version of the HAP that predicts survival of patients with HCC treated with TACE in Europe and Asia. This system might be used to identify patients with HCC most likely to benefit from TACE in clinical practice.
Issue Date: 18-Dec-2014
Date of Acceptance: 1-Dec-2014
URI: http://hdl.handle.net/10044/1/48975
DOI: https://dx.doi.org/10.1016/j.cgh.2014.11.037
ISSN: 1542-3565
Publisher: WB Saunders
Start Page: 1204
End Page: 1208
Journal / Book Title: Clinical Gastroenterology and Hepatology
Volume: 13
Issue: 6
Copyright Statement: © 2015 by the AGA Institute. This manuscript is 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
Outcome
Liver Cancer
Therapy
Hepatic
AUROC
UNRESECTABLE HEPATOCELLULAR-CARCINOMA
RANDOMIZED CONTROLLED TRIAL
TRANSARTERIAL CHEMOEMBOLIZATION
SURVIVAL
ART
Adult
Aged
Aged, 80 and over
Asia
Carcinoma, Hepatocellular
Clinical Medicine
Embolization, Therapeutic
Europe
Female
Humans
Liver
Liver Neoplasms
Male
Middle Aged
Prognosis
Prospective Studies
Survival Analysis
Tomography, X-Ray Computed
Treatment Outcome
1103 Clinical Sciences
Publication Status: Published
Article Number: e2
Appears in Collections:Division of Surgery
Division of Cancer
Faculty of Medicine



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