scholarly journals EZ-ALBI Score for Predicting Hepatocellular Carcinoma Prognosis

Liver Cancer ◽  
2020 ◽  
Vol 9 (6) ◽  
pp. 734-743
Author(s):  
Kazuya Kariyama ◽  
Kazuhiro Nouso ◽  
Atsushi Hiraoka ◽  
Akiko Wakuta ◽  
Ayano Oonishi ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Function ◽  
Large Scale ◽  
Regression Coefficient ◽  
Information Criterion ◽  
Proportional Hazard ◽  
Cox Proportional Hazard ◽  
Highly Correlated ◽  
Survival Risk ◽  
Good Agreement

<b><i>Introduction:</i></b> The ALBI score is acknowledged as the gold standard for the assessment of liver function in patients with hepatocellular carcinoma (HCC). Unlike the Child-Pugh score, the ALBI score uses only objective parameters, albumin (Alb) and total bilirubin (T.Bil), enabling a better evaluation. However, the complex calculation of the ALBI score limits its applicability. Therefore, we developed a simplified ALBI score, based on data from a large-scale HCC database.We used the data of 5,249 naïve HCC cases registered in eight collaborating hospitals. <b><i>Methods:</i></b> We developed a new score, the EZ (Easy)-ALBI score, based on regression coefficients of Alb and T.Bil for survival risk in a multivariate Cox proportional hazard model. We also developed the EZ-ALBI grade and EZ-ALBI-T grade as alternative options for the ALBI grade and ALBI-T grade and evaluated their stratifying ability. <b><i>Results:</i></b> The equation used to calculate the EZ-ALBI score was simple {[T.Bil (mg/dL)] – [9 × Alb (g/dL)]}; this value highly correlated with the ALBI score (correlation coefficient, 0.981; <i>p</i> &#x3c; 0.0001). The correlation was preserved across different Barcelona clinic liver cancer grade scores (regression coefficient, 0.93–0.98) and across different hospitals (regression coefficient, 0.98–0.99), indicating good generalizability. Although a good agreement was observed between ALBI and EZ-ALBI, discrepancies were observed in patients with poor liver function (T.Bil, ≥3 mg/dL; regression coefficient, 0.877). The stratifying ability of EZ-ALBI grade and EZ-ALBI-T grade were good and their Akaike’s information criterion values (35,897 and 34,812, respectively) were comparable with those of ALBI grade and ALBI-T grade (35,914 and 34,816, respectively). <b><i>Conclusions:</i></b> The EZ-ALBI score, EZ-ALBI grade, and EZ-ALBI-T grade are useful, simple scores, which might replace the conventional ALBI score in the future.

scholarly journals Characteristics and prognosis of hepatocellular carcinoma in multi-transfused patients with thalassemia major. Experience of a single tertiary center.

2020 ◽  
Vol 12 (1) ◽  
pp. e2020013
Author(s):  
Nikolaos Papadopoulos ◽  
Dimitrios Kountouras ◽  
Katerina Malagari ◽  
Maria Tampaki ◽  
Maria Theochari ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Survival Time ◽  
Median Survival ◽  
Median Survival Time ◽  
Iron Concentration ◽  
Thalassemia Major ◽  
Proportional Hazard ◽  
Liver Iron ◽  
Cox Proportional Hazard ◽  
Tertiary Center

Background: In this retrospective study, records of patients with thalassemia major (TM) diagnosed with hepatocellular carcinoma (HCC) from 2008‐2018 were reviewed in order to determine the survival rate and evaluate possible etiological factors associated with survival. Methods: Forty-two TM patients who were diagnosed with HCC have been included in the study. Most of our patients (78.5%) were anti-HCV positive, while 16.5% had evidence of resolved HBV infection. At the time of HCC diagnosis, 78.5% of our patients were diagnosed with cirrhosis, while the vast majority (98%) had normal or mild elevated liver iron concentration (LIC) values. According to Barcelona Clinic Liver Cancer (BCLC) grading system patients were classified as 0-A: 28.5%, B: 57% and as C-D: 14.5%.  HCC has been treated with loco-regional treatment in 78.5% of our patients, while the rest have been treated with sorafenib. Results: Twenty-eight patients (66.5%) have eventually died with a median survival time of 6 months (range: 2-60). Using the Cox proportional hazard model, the only factors who have been associated with poor survival were BCLC stages C and D. Conclusions: In conclusion, BCLC staging is the main prognostic factor of survival in patients with TM who develop HCC, with a median survival time of six months.

scholarly journals Association Between Acid-Suppressive Agents’ Use and Risk of Hepatocellular Carcinoma

Dose-Response ◽  
2020 ◽  
Vol 18 (2) ◽  
pp. 155932582090753
Author(s):  
Hsiu C. Lin ◽  
Huan Y. Hsu ◽  
Hsiu L. Lin ◽  
Yow S. Uang ◽  
Yi Ho ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Comparison Group ◽  
Gastrointestinal Diseases ◽  
Population Based ◽  
Dose Effect ◽  
Proportional Hazard ◽  
Cox Proportional Hazard ◽  
Defined Daily Doses ◽  
Matched Comparison ◽  
Dose Dependent

Background: Acid-suppressive agents (ASAs), which are mostly used in patients with upper gastrointestinal diseases (UGIDs), may influence the risk of hepatocellular carcinoma (HCC). Methods: A population-based retrospective cohort study was conducted. Patients with UGID who used ASAs and those who did not receive ASAs were identified. Patients without UGIDs were randomly selected and matched (comparison group). All groups were followed up for 6 years. A Cox proportional hazard model was used to estimate the risk of HCC among the different groups. Results: Patients with UGID who used ASAs had a significantly elevated HCC risk (adjusted hazard ratio [HR] 1.53; 95% confidence interval [CI], 1.32-1.76] compared to those who did not use ASAs. Patients with UGID who used more than 540 defined daily doses of ASAs had a significantly higher risk of HCC (adjusted HR 2.04; 95% CI, 1.62-2.58). Moreover, the dose effect on HCC risk exhibited a significant increasing trend ( P < .01). Furthermore, patients with UGID who did not use ASAs had a significantly elevated HCC risk (adjusted HR 1.94; 95% CI, 1.59-2.36) compared to the comparison group. Conclusion: The use of ASAs increased the risk of HCC in patients with UGIDs, and the effect of ASAs was dose dependent. In addition, UGIDs alone increased the risk of HCC.

scholarly journals Peritumoral EpCAM Is an Independent Prognostic Marker after Curative Resection of HBV-Related Hepatocellular Carcinoma

2017 ◽  
Vol 2017 ◽  
pp. 1-8 ◽  
Author(s):  
Xiao-Meng Dai ◽  
Tao Huang ◽  
Sheng-Li Yang ◽  
Xiu-Mei Zheng ◽  
George G. Chen ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Prognostic Marker ◽  
Tumor Biology ◽  
Proportional Hazard ◽  
Independent Prognostic Marker ◽  
Cox Proportional Hazard ◽  
Good Target ◽  
B Virus ◽  
Cox Proportional Hazard Regression ◽  
Curative Hepatectomy

Accumulating evidence suggests that the tumor microenvironment has a profound influence on tumor initiation and progression, opening a new avenue for studying tumor biology. Nonetheless, the prognostic values of the peritumoral expression of EpCAM and CD13 remain to be elucidated in hepatocellular carcinoma (HCC) patients. In this study, the expression of EpCAM and CD13 was assessed by immunohistochemistry in peritumoral liver hepatocytes from 106 hepatitis B virus- (HBV-) related HCC patients who had undergone curative hepatectomy. The peritumoral EpCAM-positive group had a significantly worse overall survival (OS) (p=0.003) and recurrence-free survival (RFS) (p=0.022) compared to the negative group. Peritumoral CD13-positive patients were also associated with poor OS (p=0.038), while not significantly associated with RFS. The adjusted multivariate COX proportional hazard regression analysis suggested that only the positive expression of peritumoral EpCAM precisely predicted poor OS. Being peritumoral EpCAM positive was also significantly associated with a larger tumor size, liver cirrhosis, and more frequent vascular invasion; however, no statistically significant association was observed between CD13 and any clinicopathological features. Taken together, peritumoral EpCAM and CD13 expression was associated with a poor prognosis, but EpCAM may be a better prognostic marker than CD13 in HBV-related HCC patients. In the future, peritumoral EpCAM could be a good target for adjuvant therapy after curative hepatectomy.

scholarly journals Performance of initial LI-RADS 2018 treatment response in predicting survival of patients with hepatocellular carcinoma following TACE: a retrospective, single-center cohort study

2021 ◽  
Author(s):  
Krzysztof Bartnik ◽  
Joanna Podgórska ◽  
Grzegorz Rosiak ◽  
Krzysztof Korzeniowski ◽  
Jakub Giziński ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Treatment Response ◽  
Interobserver Agreement ◽  
Staging System ◽  
Cancer Staging ◽  
Liver Imaging ◽  
Proportional Hazard ◽  
Proportional Hazard Model ◽  
Cox Proportional Hazard ◽  
Primary Endpoints

Abstract Purpose Treatment response following transarterial chemoembolization (TACE) is frequently evaluated with Liver Imaging Reporting and Data System Treatment Response (LR-TR) algorithm, but its association with patients’ outcomes is not supported in the literature. The purpose of this study was to provide such data. Methods A retrospective analysis of 99 TACE patients with stage A/B hepatocellular carcinoma according to Barcelona-Clinic Liver Cancer staging system was performed. Two radiologists assessed LR-TR, while a third radiologist re-assessed divergent results. Overall survival (OS) and time to disease progression (TTP) were the primary endpoints of the study, while the Cox proportional hazard model was used for outcome analyses. Results Interobserver agreement was substantial between the two readers with κ = 0.69 (95% CI 0.58–0.81). The median OS in viable, equivocal, and non-viable groups were 27, 27, and 73 months, respectively (p < 0.001). However, after adjustment for confounding factors, there was no significant association between initial viable response and OS (HR 0.98 [95% CI 0.37–2.63], p = 0.97), while equivocal response remained statistically significant (HR 3.52. [95% CI 1.27–9.71], p = 0.015). No significant association was noted when viable and equivocal groups were analyzed in aggregate (HR 1.03 [95% CI 0.4–2.4], p = 0.96). The median TTP did not differ between non-viable and viable groups (23 vs 18 months, respectively; p = 0.98). None of the analyzed predictors was associated with TTP. Conclusion Initial LR-TR response was not an independent predictor for OS nor TTP. The preliminary results suggest the necessity for more aggressive management of equivocal patients.

Outcomes after treatment of resectable, node-negative esophageal cancer: A risk-adjusted analysis of the Surveillance, Epidemiology, and End Results registry.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e14562-e14562
Author(s):  
Jeremiah Thomas Martin ◽  
Mathias Worni ◽  
Joseph Bertram Zwischenberger ◽  
Ricardo Pietrobon ◽  
Thomas A. D'Amico ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Tumor Resection ◽  
Proportional Hazard ◽  
Nodal Disease ◽  
Node Negative ◽  
T Stage ◽  
Cox Proportional Hazard ◽  
Kaplan Meier ◽  
Cox Proportional Hazard Models ◽  
Survival Risk

e14562 Background: Esophageal cancer has poor prognosis even in early stages. We examined survival for patients with resectable tumors in the absence of nodal disease in order to assess the benefits of surgery and radiation. Methods: Patients with T1-T3N0M0 squamous cell or adenocarcinoma of the mid or distal esophagus were identified using the SEER database from 1998-2008. The Kaplan-Meier approach and risk-adjusted Cox proportional-hazard models were used to assess 5-year overall survival. Survival risk among treatment modality subgroups (surgery only (SO), radiotherapy only (RO), combined surgery and radiotherapy (CT), and local tumor resection (LR)) was evaluated for the overall patient cohort and stratified among T-stage. SEER does not record chemotherapy use, which therefore wasn’t analyzed. Results: Overall 5-year survival for 4,251 patients identified (mean age 67.7±11.4 years, 966 (22.7%) female) was 37.6% (95% CI: 35.8-39.4). Survival correlated with T-stage: T1N0 48.0% (45.4-50.6); T2N0 29.8% (26.1-33.5); and T3N0 25.8% (22.9-28.7), p<0.001. For T1N0 patients, risk-adjusted survival was better with SO compared to CT (HR: 0.84, CI: 0.74-0.96, p=0.01) while LR and SO were not significantly different (p=0.24) (Table). Treatment with SO or CT had better survival compared to RO for T2N0 and T3N0 patients. The addition of radiation to surgery (CT vs. SO) improved survival for T3N0 patients (HR 0.79, CI 0.65-0.97, p=0.03) but not T2N0 patients (HR: 1.05, CI: 0.81-1.37, p=0.71). Conclusions: Surgical resection without radiation therapy is adequate for T1N0 esophageal cancer, but combined radiation and surgery has the best outcomes for T3N0 patients. Prognoses of T2N0 cancers are more similar to T3N0 cancers than T1N0 cancers, but no survival benefit to adding radiation to surgery for T2N0 patients was seen in this study. [Table: see text]

scholarly journals P0779THE POPULATION ATTRIBUTABLE FRACTION OF HYPERURICEMIA FOR ALL-CAUSE AND CARDIOVASCULAR MORTALITY: A NATIONWIDE COMMUNITY-BASED STUDY

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Tomomi Tanaka ◽  
Tomomi Tanaka ◽  
Masahiro Miyata ◽  
Kazunobu Ichikawa ◽  
Tsuneo Konta ◽  
...  
Keyword(s):  
Cardiovascular Mortality ◽  
Large Scale ◽  
Hazard Analysis ◽  
Population Attributable Fraction ◽  
Attributable Fraction ◽  
Proportional Hazard ◽  
Community Based ◽  
Cox Proportional Hazard ◽  
Hazard Ratios

Abstract Background and Aims Hyperuricemia is often observed in subjects with chronic kidney disease and is associated with all-cause and cardiovascular mortality. In this study, we evaluated the effect size of hyperuricemia for all-cause and cardiovascular mortality in a community-based population, using the index of population attributable fraction (PAF). Method This large-scale cohort study used the nationwide database of 500,511 health check-up participants (215,728 men, 284,783 women, average age 62 years) and calculated the PAF of hyperuricemia (serum uric acid &gt;7 mg/dL) for all-cause and cardiovascular deaths during the 7-year follow-up period. Results The frequency of hyperuricemia at baseline was 9.7% in total subjects (men: 22.0%; women: 2.6%). During the follow-up period, 5,578 deaths (1.1%) were noted (men: 3,749 [1.7%], women: 1,829 [0.6%]), including 1,104 cardiovascular deaths (0.2%) (men: 762 [0.4%], women: 342 [0.1%]). In the Cox proportional hazard analysis adjusted for confounding factors including age, gender, body mass index, smoking, alcohol consumption, hypertension, diabetes, dyslipidemia and eGFR, hyperuricemia was an independent risk factor for all-cause and cardiovascular mortality, (adjusted hazard ratios [95% confidence interval]; 1.39 [1.27-1.53] for all-cause mortality, and 1.76 [1.47-2.11] for cardiovascular mortality). The adjusted PAF of hyperuricemia for all-cause and cardiovascular deaths were 3.1% and 4.7% (approximately 1 in 32 all-cause deaths, and 1 in 21 cardiovascular deaths), respectively. In subgroup analyses, the association between hyperuricemia and death was stronger in men and smokers. The adjusted PAF for all-cause and cardiovascular deaths was 5.5% and 8.6% (approximately 1 in 18 all-cause deaths, 1 in 12 cardiovascular deaths) in men, and 6.2% and 8.2% (approximately 1 in 16 all-cause deaths, 1 in 12 cardiovascular deaths) in smokers, respectively. Conclusion This study showed that a substantial number of all-cause and cardiovascular deaths, was statistically attributed to hyperuricemia in the community-based population, especially men and smokers.

scholarly journals Genetic Polymorphisms in CD35 Gene Contribute to the Susceptibility and Prognosis of Hepatocellular Carcinoma

2021 ◽  
Vol 11 ◽  
Author(s):  
Limei Luo ◽  
Qin Li ◽  
Zhenzhen Su ◽  
Lixin Li ◽  
Bei Cai ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Postoperative Recurrence ◽  
Proportional Hazard ◽  
Chinese Han ◽  
Tag Snps ◽  
Flight Mass Spectrometry ◽  
Cox Proportional Hazard ◽  
Significant Independent Risk Factor ◽  
Gene Environment ◽  
The Relationship

CD35, an important molecule implicated in inflammation and immunity, is reportedly associated with several cancers. However, very few studies have investigated the relationship between CD35 polymorphisms and hepatocellular carcinoma (HCC). The current study was conducted to investigate the association between tag SNPs in CD35 and HCC susceptibility and postoperative recurrence, in an attempt to elucidate the gene-environment interactions in HCC. A total of 1233 Chinese Han people, including 647 healthy controls and 586 HCC cases, were sampled in this study. Six Tag SNPs (rs10494885, rs2296160, rs3737002, rs3849266, rs669117, and rs7525160) of CD35 were selected using the HaploView 4.2 program and genotyped by matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF-MS). Overall, the mutation genotypes CC/CG of CD35 rs7525160 significantly increased the risk of HCC. Stratification analysis indicated that CD35 rs7525160 CC/CG genotypes increased HCC risk in patients younger than 65 years and were closely related to the pathological type of poor prognosis of HCC. Cox proportional hazard ratio model analysis revealed that the rs7525160 CC/CG genotype remains a significant independent risk factor for postoperative recurrence of HCC. In conclusion, CD35 rs7525160 polymorphism may contribute to the susceptibility and prognosis of HCC in the Chinese Han population.

scholarly journals Performance of initial LI-RADS 2018 treatment response in predicting survival of patients with hepatocellular carcinoma following TACE: a retrospective, single-center cohort study

2021 ◽  
Author(s):  
Krzysztof Bartnik ◽  
Joanna Podgórska ◽  
Grzegorz Rosiak ◽  
Krzysztof Korzeniowski ◽  
Jakub Giziński ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Treatment Response ◽  
Interobserver Agreement ◽  
Staging System ◽  
Cancer Staging ◽  
Liver Imaging ◽  
Proportional Hazard ◽  
Proportional Hazard Model ◽  
Cox Proportional Hazard ◽  
Primary Endpoints

Abstract Purpose Treatment response following transarterial chemoembolization (TACE) is frequently evaluated with Liver Imaging Reporting and Data System Treatment Response (LR-TR) algorithm, but its association with patients outcomes is not supported in the literature. The purpose of this study was to provide such data. Methods A retrospective analysis of 99 TACE patients with stage A/B hepatocellular carcinoma according to Barcelona Clinic Liver Cancer staging system was performed. Two radiologists assessed LR-TR, while a third radiologist re-assessed divergent results. Overall survival (OS) and time to disease progression (TTP) were the primary endpoints of the study, while the Cox proportional hazard model was used for outcome analyses. Results Interobserver agreement was substantial between the two readers with κ = 0.69 (95% CI: 0.58–0.81). The median OS in viable, equivocal and non-viable groups were 27, 27 and 73 months, respectively (p < 0.001). However, after adjustment for confounding factors, there was no significant association between initial viable response and OS (HR 0.98 [95% CI: 0.37–2.63], p = 0.97), while equivocal response remained statistically significant (HR 3.52. [95% CI: 1.27–9.71], p = 0.015). No significant association was noted when viable and equivocal groups were analyzed in aggregate (HR 1.03 [95% CI: 0.4–2.4], p = 0.96). The median TTP did not differ between non-viable and viable groups (23 vs 18 months, respectively; p = 0.98). None of the analyzed predictors was associated with TTP. Conclusion Initial LR-TR response was not an independent predictor for OS nor TTP. The preliminary results suggest the necessity for more aggressive management of equivocal patients.

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