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

文献类型：期刊论文

作者Sun, Hui-Chuan1; Yang, Xin-Rong1; Zhu, Xiao-Dong1; Xu, Yang1; Hu, Bo1; Shil, Ying-Hong1; Zhou, Jian1; Qiu, Shuang-Jian1; Tang, Zhao-You1; Fan, Jia1
刊名CHINESE MEDICAL JOURNAL
出版日期2017
卷号130期号:22页码:2650-+
关键词Adjuvant Treatment Hepatocellular Carcinoma Prognosis Shanghai Score
ISSN号0366-6999
DOI10.4103/0366-6999.218019
文献子类Article
英文摘要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, gamma-glutamyltransferase, alpha-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 20102011 were enrolled as external validation cohorts. Shanghai Score was also implied in evaluating adjuvant treatment choices based on propensity score matching analysis. Results: 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 arterial chemoembolization or interferon-alpha). The identified subset of patients at low risk could be ideal candidates for curative surgery, and subsets of patients at moderate or high risk could be recommended with possible adjuvant therapies after surgery. Finally, a web server with individualized outcome prediction and treatment recommendation was constructed. Conclusions: Based on the largest cohort up to date, we established Shanghai Score - an individualized outcome prediction system specifically designed for Chinese HCC patients after surgery. The Shanghai Score web server provides an easily accessible tool to stratify the prognosis of patients undergoing liver resection for HCC.
学科主题General & Internal Medicine
WOS关键词TRANSCATHETER ARTERIAL CHEMOEMBOLIZATION ; TNM-STAGING-SYSTEM ; CANCER STATISTICS ; LIVER RESECTION ; SURVIVAL ; HEPATECTOMY ; TRIAL ; RECURRENCE ; PREDICTION ; NOMOGRAMS
语种英语
CSCD记录号CSCD:31408335
WOS记录号WOS:000415226900002
出版者MEDKNOW PUBLICATIONS & MEDIA PVT LTD
版本出版稿
源URL[http://202.127.25.144/handle/331004/1254]  
专题中国科学院上海生命科学研究院营养科学研究所
作者单位1.Fudan Univ, Liver Canc Inst, Zhongshan Hosp,Minist Educ, Dept Liver Surg,Key Lab Carcinogenesis & Canc Inv, Shanghai 200032, Peoples R China;
2.Shanghai Acad Sci & Technol, Shanghai Ctr Bioinformat Technol, Shanghai 201203, Peoples R China;
3.Huazhong Univ Sci & Technol, Wuhan Natl Lab Optoelect, Britton Chance Ctr Biomed Photon, Wuhan 430074, Hubei, Peoples R China;
4.Chinese Acad Sci, Shanghai Inst Biol Sci, CAS MPG Partner Inst Computat Biol, Key Lab Computat Biol, Shanghai 200031, Peoples R China;
5.Second Mil Med Univ, Eastern Hepatobiliary Surg Hosp, Dept Hepat Surg, Shanghai 200438, Peoples R China;
6.Tianjin Med Univ Canc Inst & Hosp, Dept Hepatobiliary Surg, Tianjin 300040, Peoples R China;
7.Vanderbilt Univ, Sch Med, Ctr Quantitat Sci, Nashville, TN 37232 USA,
推荐引用方式
GB/T 7714		 Sun, Hui-Chuan,Yang, Xin-Rong,Zhu, Xiao-Dong,et al. Shanghai Score: A Prognostic and Adjuvant Treatment-evaluating System Constructed for Chinese Patients with Hepatocellular Carcinoma after Curative Resection[J]. CHINESE MEDICAL JOURNAL,2017,130(22):2650-+.
APA Sun, Hui-Chuan.,Yang, Xin-Rong.,Zhu, Xiao-Dong.,Xu, Yang.,Hu, Bo.,...&,.(2017).Shanghai Score: A Prognostic and Adjuvant Treatment-evaluating System Constructed for Chinese Patients with Hepatocellular Carcinoma after Curative Resection.CHINESE MEDICAL JOURNAL,130(22),2650-+.
MLA Sun, Hui-Chuan,et al."Shanghai Score: A Prognostic and Adjuvant Treatment-evaluating System Constructed for Chinese Patients with Hepatocellular Carcinoma after Curative Resection".CHINESE MEDICAL JOURNAL 130.22(2017):2650-+.

入库方式： OAI收割

来源：上海营养与健康研究所

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