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shanghai score： A Prognostic and Adjuvant Treatment-evaluating System Constructed for Chinese Patients with Hepatocellular Carcinoma after Curative Resection

引用

Chinese Medical Journal 2017年第22期130卷 2650-2660页

作者： Hui-Chuan Sun Lu Xie Xin-Rong Yang Wei Li Jian Yu Xiao-Dong Zhu Yong Xia Ti Zhang Yang Xu Bo Hu Li-Ping Du Ling-Yao Zeng Jian Ouyang Wei Zhang Tian-Qiang Song Qiang Li Ying-Hong Shi Jian Zhou Shuang-Jian Qiu Qian Liu Yi-Xue Li Zhao-You Tang Yu Shyr Feng Shen Jia Fan Department of Liver Surgery Liver Cancer Institute Zhongshan Hospital Fudan University Key Laboratory of Carcinogenesis and Cancer Invasion Ministry of Education Shanghai 200032 China shanghai Center for Bioinformation Technology Shanghai Academy of Science and Technology Shanghai 201203 China Britton Chance Center for Biomedical Photonics Wuhan National Laboratory for Optoelectronics Huazhong University of Science and Technology Wuhan Hubei 430074 China Key Laboratory of Computational Biology CAS-MPG Partner Institute for Computational Biology Shanghai Institutes for Biological Sciences Chinese Academy of Sciences Shanghai 200031 China Department of Hepatic Surgery Eastern Hepatobiliary Surgery Hospital The Second Military Medical University Shanghai 200438 China Department of Hepatobiliary Surgery Tianjin Medical University Cancer Institute and Hospital Tianjin 300040 China Center for Quantitative Sciences Vanderbilt University School of Medicine Nashville TN 37232 USA

Background： For Chinese patients with hepatocellular carcinoma （HCC）, surgical resection is the most important treatment to achieve long-term survival for patients with an early-stage tumor, and yet the prognosis after surgery is diverse. We aimed to construct a scoring system （shanghai score） for individualized prognosis estimation and adjuvant treatment evaluation. Methods： A multivariate Cox proportional hazards model was constructed based on 4166 HCC patients undergoing resection during 2001-2008 at Zhongshan Hospital. Age, hepatitis B surface antigen, hepatitis B e antigen, partial thromboplastin time, total bilirubin, alkaline phosphatase, y-glutamyltransferase, a-fetoprotein, tumor size, cirrhosis, vascular invasion, differentiation, encapsulation, and tumor number were finally retained by a backward step-down selection process with the Akaike information criterion. The Harrell＇s concordance index （C-index） was used to measure model performance. shanghai score is calculated by summing the products of the 14 variable values times each variable＇s corresponding regression coefficient. Totally 1978 patients from Zhongshan Hospital undergoing resection during 2009-2012, 808 patients from Eastern Hepatobiliary Surgery Hospital during 2008-2010, and 244 patients from Tianjin Medical University Cancer Hospital during 2010-2011 were enrolled as external validation cohorts. shanghai score was also implied in evaluating adjuvant treatment choices based on propensity score matching ***： shanghai score showed good calibration and discrimination in postsurgical HCC patients. The bootstrap-corrected C-index （confidence interval [CI]） was 0.74 for overall survival （OS） and 0.68 for recurrence-free survival （RFS） in derivation cohort （4166 patients）, and in the three independent validation cohorts, the CIs for OS ranged 0.70 0.72 and that for RFS ranged 0.63 0.68. Furthermore, shanghai score provided evaluation for adjuvant treatment choices （transcatheter arteri

关键词： Adjuvant Treatment Hepatocellular Carcinoma Prognosis shanghai score

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