Validation of a model to estimate survival in ambulatory patients with hepatocellular carcinoma: A single-centre cohort study

Bo Hyun Kim, Joong Won Park, Byung Ho Nam, Hee Won Kwak, W. Ray Kim

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Survival of patients with hepatocellular carcinoma (HCC) is determined by hepatic function and tumour extent. Recently, a new Model to Estimate Survival in Ambulatory HCC patients (MESIAH) was proposed to predict overall survival in ambulatory HCC patients. This study aimed to evaluate the prognostic performance of the MESIAH score in an independent cohort of HCC patients. Methods: A cohort of 1969 patients newly diagnosed with HCC at the National Cancer Center, Korea between January 2004 and December 2009 was used for validation of the MESIAH score. The model's performance was assessed using C-statistics, the likelihood ratio (LR) χ2 value and Akaike information criterion (AIC). Results: Patients in the cohort had a median age of 56 years and 83.2% were men. Hepatitis B virus infection was present in 74.6 and 81.6% had a Child-Pugh class A. The median overall survival was 21.4 months. The MESIAH score had a higher degree of discrimination, with a C-statistic of 0.792 [95% confidence interval (CI), 0.782-0.803], when compared with the Barcelona Clinic Liver Cancer (BCLC) staging system [0.665 (95% CI, 0.653-0.678), P < 0.001]. The LR χ2 value and the AIC of MESIAH were also better than those of BCLC, Cancer of the Liver Italian Program, Japan Integrated Scoring and Tokyo score. The observed survival in the cohort closely matched that predicted by the MESIAH score. Conclusions: The new prognostication model MESIAH accurately estimated the overall survival of Korean HCC patients and may be useful in future research as well as individual patient care.

Original languageEnglish (US)
JournalLiver International
Volume34
Issue number7
DOIs
StatePublished - 2014

Fingerprint

Hepatocellular Carcinoma
Cohort Studies
Survival
Liver Neoplasms
Confidence Intervals
Tokyo
Neoplasm Staging
Virus Diseases
Korea
Hepatitis B virus
Neoplasms
Patient Care
Japan
Liver

Keywords

  • BCLC
  • Hepatocellular carcinoma
  • MELD
  • MESIAH
  • Prognosis

ASJC Scopus subject areas

  • Hepatology

Cite this

Validation of a model to estimate survival in ambulatory patients with hepatocellular carcinoma : A single-centre cohort study. / Kim, Bo Hyun; Park, Joong Won; Nam, Byung Ho; Kwak, Hee Won; Kim, W. Ray.

In: Liver International, Vol. 34, No. 7, 2014.

Research output: Contribution to journalArticle

Kim, Bo Hyun ; Park, Joong Won ; Nam, Byung Ho ; Kwak, Hee Won ; Kim, W. Ray. / Validation of a model to estimate survival in ambulatory patients with hepatocellular carcinoma : A single-centre cohort study. In: Liver International. 2014 ; Vol. 34, No. 7.
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abstract = "Survival of patients with hepatocellular carcinoma (HCC) is determined by hepatic function and tumour extent. Recently, a new Model to Estimate Survival in Ambulatory HCC patients (MESIAH) was proposed to predict overall survival in ambulatory HCC patients. This study aimed to evaluate the prognostic performance of the MESIAH score in an independent cohort of HCC patients. Methods: A cohort of 1969 patients newly diagnosed with HCC at the National Cancer Center, Korea between January 2004 and December 2009 was used for validation of the MESIAH score. The model's performance was assessed using C-statistics, the likelihood ratio (LR) χ2 value and Akaike information criterion (AIC). Results: Patients in the cohort had a median age of 56 years and 83.2{\%} were men. Hepatitis B virus infection was present in 74.6 and 81.6{\%} had a Child-Pugh class A. The median overall survival was 21.4 months. The MESIAH score had a higher degree of discrimination, with a C-statistic of 0.792 [95{\%} confidence interval (CI), 0.782-0.803], when compared with the Barcelona Clinic Liver Cancer (BCLC) staging system [0.665 (95{\%} CI, 0.653-0.678), P < 0.001]. The LR χ2 value and the AIC of MESIAH were also better than those of BCLC, Cancer of the Liver Italian Program, Japan Integrated Scoring and Tokyo score. The observed survival in the cohort closely matched that predicted by the MESIAH score. Conclusions: The new prognostication model MESIAH accurately estimated the overall survival of Korean HCC patients and may be useful in future research as well as individual patient care.",
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AU - Kim, W. Ray

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N2 - Survival of patients with hepatocellular carcinoma (HCC) is determined by hepatic function and tumour extent. Recently, a new Model to Estimate Survival in Ambulatory HCC patients (MESIAH) was proposed to predict overall survival in ambulatory HCC patients. This study aimed to evaluate the prognostic performance of the MESIAH score in an independent cohort of HCC patients. Methods: A cohort of 1969 patients newly diagnosed with HCC at the National Cancer Center, Korea between January 2004 and December 2009 was used for validation of the MESIAH score. The model's performance was assessed using C-statistics, the likelihood ratio (LR) χ2 value and Akaike information criterion (AIC). Results: Patients in the cohort had a median age of 56 years and 83.2% were men. Hepatitis B virus infection was present in 74.6 and 81.6% had a Child-Pugh class A. The median overall survival was 21.4 months. The MESIAH score had a higher degree of discrimination, with a C-statistic of 0.792 [95% confidence interval (CI), 0.782-0.803], when compared with the Barcelona Clinic Liver Cancer (BCLC) staging system [0.665 (95% CI, 0.653-0.678), P < 0.001]. The LR χ2 value and the AIC of MESIAH were also better than those of BCLC, Cancer of the Liver Italian Program, Japan Integrated Scoring and Tokyo score. The observed survival in the cohort closely matched that predicted by the MESIAH score. Conclusions: The new prognostication model MESIAH accurately estimated the overall survival of Korean HCC patients and may be useful in future research as well as individual patient care.

AB - Survival of patients with hepatocellular carcinoma (HCC) is determined by hepatic function and tumour extent. Recently, a new Model to Estimate Survival in Ambulatory HCC patients (MESIAH) was proposed to predict overall survival in ambulatory HCC patients. This study aimed to evaluate the prognostic performance of the MESIAH score in an independent cohort of HCC patients. Methods: A cohort of 1969 patients newly diagnosed with HCC at the National Cancer Center, Korea between January 2004 and December 2009 was used for validation of the MESIAH score. The model's performance was assessed using C-statistics, the likelihood ratio (LR) χ2 value and Akaike information criterion (AIC). Results: Patients in the cohort had a median age of 56 years and 83.2% were men. Hepatitis B virus infection was present in 74.6 and 81.6% had a Child-Pugh class A. The median overall survival was 21.4 months. The MESIAH score had a higher degree of discrimination, with a C-statistic of 0.792 [95% confidence interval (CI), 0.782-0.803], when compared with the Barcelona Clinic Liver Cancer (BCLC) staging system [0.665 (95% CI, 0.653-0.678), P < 0.001]. The LR χ2 value and the AIC of MESIAH were also better than those of BCLC, Cancer of the Liver Italian Program, Japan Integrated Scoring and Tokyo score. The observed survival in the cohort closely matched that predicted by the MESIAH score. Conclusions: The new prognostication model MESIAH accurately estimated the overall survival of Korean HCC patients and may be useful in future research as well as individual patient care.

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