Development of a survival evaluation model for liver transplant recipients with hepatocellular carcinoma secondary to hepatitis B
Development of a survival evaluation model for liver transplant recipients with hepatocellular carcinoma secondary to hepatitis B作者机构：Liver Transplantation Center West China Hospital Sichuan University Medical School Chengdu610041 Sichuan Province China Department of Biostatistics West China School of PublicHealth Sichuan University Chengdu 610041 Sichuan ProvinceChina
出 版 物：《World Journal of Gastroenterology》 (世界胃肠病学杂志（英文版）)
年 卷 期：2008年第14卷第8期
页 面：1280-1285页
核心收录：
学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学]
基 金：The National Basic Research Program of China 973 Program No. 2003CB515504
主 题：Liver neoplasms Hepatitis B Liver transplantation Survival evaluation Model for End StageLiver Disease
摘 要：AIM:To develop a model using easily obtainable, objective, verifiable preoperative parameters, to help evaluate post transplant survival probability for hepatocellular carcinoma (HCC) patients with hepatitis B. METHODS:We retrospectively examined a cohort of 150 consecutive primary cadaveric liver transplants with HCC in our center over 6 years. Thirteen preoperative biochemical parameters and six tumor-related factors were analyzed to identify their correlation with post transplant survival using the Cox proportional-hazards regression model. The predictive power of a new model and the model for end stage liver disease was compared by the receiver operating characteristic curve. RESULTS:In univariate analysis, the factors significantly associated with post transplant survival were serum concentrations of albumin, total bilirubin, alkaline phosphatase, alpha-fetoprotein, γ-glutamyltransferase, aspartate aminotransferase, sodium, tumor diameter and the number of tumor nodules. Multivariate analysis showed alpha-fetoprotein, serum sodium, alkaline phosphatase and the number of tumor nodules were significantly associated with the post transplant outcome. Based on the four variables, we established a new model with a c-statistic of 0.72 which was significantly greater than 0.50 (P = 0.001), and the c-statistic of MELD was 0.59 (P = 0.146).CONCLUSION:The new model based on four objective tumor-related parameters has the capacity to evaluate the risk of post transplant mortality for HCC patients with hepatitis B.
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