TY - JOUR
T1 - Modified integrated tumor burden, liver function, systemic inflammation, and tumor biology score to predict long-term outcomes after resection for hepatocellular carcinoma
AU - Endo, Yutaka
AU - Moazzam, Zorays
AU - Alaimo, Laura
AU - Woldesenbet, Selamawit
AU - Lima, Henrique A.
AU - Munir, Muhammad M.
AU - Katayama, Erryk
AU - Yang, Jason
AU - Azap, Lovette
AU - Shaikh, Chanza F.
AU - Ratti, Francesca
AU - Marques, Hugo P.
AU - Cauchy, François
AU - Lam, Vincent
AU - Poultsides, George A.
AU - Kitago, Minoru
AU - Popescu, Irinel
AU - Alexandrescu, Sorin
AU - Martel, Guillaume
AU - Guglielmi, Alfredo
AU - Gleisner, Ana
AU - Hugh, Tom
AU - Aldrighetti, Luca
AU - Shen, Feng
AU - Endo, Itaru
AU - Pawlik, Timothy M.
PY - 2023/12
Y1 - 2023/12
N2 - Background: A preoperative predictive score for hepatocellular carcinoma (HCC) can help stratify patients who undergo resection relative to long-term outcomes and tailor treatment strategies. Methods: Patients who underwent curative-intent hepatectomy for HCC between 2000 and 2020 were identified from an international multi-institutional database. A risk score (mFIBA) was developed using an Eastern cohort and then validated using a Western cohort. Results: Among 957 patients, 443 and 514 patients were included from the Eastern and Western cohorts, respectively. On multivariable analysis, alpha-feto protein (HR1.97, 95%CI 1.42–2.72), neutrophil-to-lymphocyte ratio (HR1.74, 95%CI 1.28–2.38), albumin-bilirubin grade (HR1.66, 95%CI 1.21–2.28), and imaging tumor burden score (HR1.25, 95%CI 1.12–1.40) were associated with OS. The c-index in the Eastern test and Western validation cohorts were 0.69 and 0.67, respectively. Notably, mFIBA score outperformed previous HCC staging systems. 5-year OS incrementally decreased with an increase in mFIBA. On multivariable Cox regression analysis, the mFIBA score was associated with worse OS (HR1.18, 95%CI 1.13–1.23) and higher risk of recurrence (HR1.16, 95%CI 1.11–1.20). An easy-to-use calculator of the mFIBA score was made available online (https://yutaka-endo.shinyapps.io/mFIBA_score/). Discussion: The online mFIBA calculator may help surgeons with clinical decision-making to individualize perioperative treatment strategies for patients undergoing resection of HCC.
AB - Background: A preoperative predictive score for hepatocellular carcinoma (HCC) can help stratify patients who undergo resection relative to long-term outcomes and tailor treatment strategies. Methods: Patients who underwent curative-intent hepatectomy for HCC between 2000 and 2020 were identified from an international multi-institutional database. A risk score (mFIBA) was developed using an Eastern cohort and then validated using a Western cohort. Results: Among 957 patients, 443 and 514 patients were included from the Eastern and Western cohorts, respectively. On multivariable analysis, alpha-feto protein (HR1.97, 95%CI 1.42–2.72), neutrophil-to-lymphocyte ratio (HR1.74, 95%CI 1.28–2.38), albumin-bilirubin grade (HR1.66, 95%CI 1.21–2.28), and imaging tumor burden score (HR1.25, 95%CI 1.12–1.40) were associated with OS. The c-index in the Eastern test and Western validation cohorts were 0.69 and 0.67, respectively. Notably, mFIBA score outperformed previous HCC staging systems. 5-year OS incrementally decreased with an increase in mFIBA. On multivariable Cox regression analysis, the mFIBA score was associated with worse OS (HR1.18, 95%CI 1.13–1.23) and higher risk of recurrence (HR1.16, 95%CI 1.11–1.20). An easy-to-use calculator of the mFIBA score was made available online (https://yutaka-endo.shinyapps.io/mFIBA_score/). Discussion: The online mFIBA calculator may help surgeons with clinical decision-making to individualize perioperative treatment strategies for patients undergoing resection of HCC.
UR - http://www.scopus.com/inward/record.url?scp=85166930218&partnerID=8YFLogxK
U2 - 10.1016/j.hpb.2023.07.901
DO - 10.1016/j.hpb.2023.07.901
M3 - Article
C2 - 37544855
AN - SCOPUS:85166930218
SN - 1365-182X
VL - 25
SP - 1484
EP - 1493
JO - HPB
JF - HPB
IS - 12
ER -