An internally validated new clinical and inflammation-based prognostic score for patients with advanced hepatocellular carcinoma treated with sorafenib
| العنوان: | An internally validated new clinical and inflammation-based prognostic score for patients with advanced hepatocellular carcinoma treated with sorafenib |
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| المؤلفون: | Ángel Segura, Alejandra Gimenez, J. Caballero, G. Bruixola, D. Akhoundova, David Lorente, Jorge Aparicio, Roberto Díaz-Beveridge, E. Rodrigo |
| المصدر: | CLINICAL & TRANSLATIONAL ONCOLOGY r-IIS La Fe. Repositorio Institucional de Producción Científica del Instituto de Investigación Sanitaria La Fe instname r-INCLIVA. Repositorio Institucional de Producción Científica de INCLIVA |
| بيانات النشر: | SPRINGER-VERLAG ITALIA SRL, 2018. |
| سنة النشر: | 2018 |
| مصطلحات موضوعية: | Oncology, Male, Cancer Research, Multivariate analysis, Cirrhosis, Neutrophils, Hepatocellular carcinoma, Severity of Illness Index, Prognostic score, 0302 clinical medicine, Medicine, Aged, 80 and over, Standard treatment, Liver Neoplasms, General Medicine, Middle Aged, Sorafenib, Prognosis, Treatment Outcome, 030220 oncology & carcinogenesis, Area Under Curve, 030211 gastroenterology & hepatology, Female, medicine.drug, Adult, Diarrhea, Niacinamide, medicine.medical_specialty, Carcinoma, Hepatocellular, Antineoplastic Agents, Prognostic factors, 03 medical and health sciences, Internal medicine, Humans, Lymphocyte Count, Aged, Proportional Hazards Models, Retrospective Studies, Inflammation, Performance status, Receiver operating characteristic, business.industry, Phenylurea Compounds, medicine.disease, ROC Curve, business, Neutrophil activation |
| الوصف: | Sorafenib is a standard treatment for patients (pts) with advanced hepatocellular carcinoma (aHCC), although the clinical benefit is heterogeneous between different pts groups. Among novel prognostic factors, a low baseline neutrophil-to-lymphocyte ratio (bNLR) and early-onset diarrhoea have been linked with a better prognosis. To identify prognostic factors in pts with aHCC treated with 1st-line sorafenib and to develop a new prognostic score to guide management. Retrospective review of 145 pts bNLR, overall toxicity, early toxicity rates and overall survival (OS) were assessed. Univariate and multivariate analysis of prognostic factors for OS was performed. The prognostic score was calculated from the coefficients found in the Cox analysis. ROC curves and pseudoR2 index were used for internal validation. Discrimination ability and calibration were tested by Harrel's c-index (HCI) and Akaike criteria (AIC). The optimal bNLR cut-off for the prediction of OS was 4 (AUC 0.62). Independent prognostic factors in multivariate analysis for OS were performance status (PS) (p < .0001), Child-Pugh (C-P) score (p = 0.005), early-onset diarrhoea (p = 0.006) and BNLR (0.011). The prognostic score based on these four variables was found efficient (HCI = 0.659; AIC = 1.180). Four risk groups for OS could be identified: a very low-risk (median OS = 48.6 months), a low-risk (median OS = 11.6 months), an intermediate-risk (median OS = 8.3 months) and a high-risk group (median OS = 4.4 months). PS and C-P score were the main prognostic factors for OS, followed by early-onset diarrhoea and bNLR. We identified four risk groups for OS depending on these parameters. This prognostic model could be useful for patient stratification, but an external validation is needed. |
| تدمد: | 1699-048X |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::60bdf7c0742c15b7d2c62c991ca8d74a https://fundanet.iislafe.san.gva.es/publicaciones/ProdCientif/PublicacionFrw.aspx?id=9221 |
| حقوق: | OPEN |
| رقم الأكسشن: | edsair.doi.dedup.....60bdf7c0742c15b7d2c62c991ca8d74a |
| قاعدة البيانات: | OpenAIRE |
Find this article in full text from Springer Verlag. | تدمد: | 1699048X |
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