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TAC Score Better Predicts Survival Than the BCLC Following Resection of Hepatocellular Carcinoma

2023-03Journal article Open access
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dc.contributor.authorLima, H
dc.contributor.authorEndo, Y
dc.contributor.authorMoazzam, Z
dc.contributor.authorAlaimo, L
dc.contributor.authorShaikh, C
dc.contributor.authorMunir, M
dc.contributor.authorResende, V
dc.contributor.authorGuglielmi, A
dc.contributor.authorPinto Marques, H
dc.contributor.authorCauchy, F
dc.contributor.authorLam, V
dc.contributor.authorPoultsides, G
dc.contributor.authorPopescu, I
dc.contributor.authorAlexandrescu, S
dc.contributor.authorMartel, G
dc.contributor.authorEndo, I
dc.contributor.authorKitago, M
dc.contributor.authorShen, F
dc.contributor.authorPawlik, T
dc.date.accessioned2024-07-30T15:25:48Z
dc.date.available2024-07-30T15:25:48Z
dc.date.issued2023-03
dc.description.abstractBackground: Heterogeneity in hepatocellular carcinoma (HCC) still exists within the Barcelona clinic liver cancer (BCLC) subcategories. We developed a simple model to better discriminate and predict prognosis following resection. Methods: Patients who underwent curative-intent resection for HCC were identified from a multi-institutional database. Predictive factors of survival were identified to develop TAC (tumor burden score [TBS], alpha-fetoprotein [AFP], Child-Pugh CP]) score. Results: Among 1435 patients, median TBS was 5.1 (interquartile range [IQR]: 3.2-8.1), median AFP was 18.3 ng/ml (IQR 4.0-362.5), and 1391 (96.9%) patients were classified as CP-A. Factors associated with overall survival (OS) included TBS (low: referent; medium: HR 2.26, 95% CI: 1.73-2.96; high: HR = 3.35, 95% CI: 2.22-5.07), AFP (<400 ng/ml: referent; >400 ng/ml: HR = 1.56, 95% CI: 1.27-1.92), and CP (A: referent; B: HR = 1.81, 95% CI: 1.12-2.92) (all p < 0.05). A simplified risk score demonstrated superior concordance index, Akaike information criteria, homogeneity, and area under the curve versus BCLC (0.620 vs. 0.541; 5484.655 vs. 5536.454; 60.099 vs. 16.194; 0.62 vs. 0.55, respectively), and further stratified patients within BCLC groups relative to OS (BCLC 0, very low: 86.8%, low: 47.8%) (BCLC A, very low: 79.7%, low: 68.1%, medium: 52.5%, high: 35.6%) (BCLC B, low: 59.8%, medium: 43.7%, high: N/A). Conclusion: TAC is a simple, holistic score that consistently outperformed BCLC relative to discrimination power and prognostication following resection of HCC.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationJ Surg Oncol . 2023 Mar;127(3):374-384.pt_PT
dc.identifier.doi10.1002/jso.27116pt_PT
dc.identifier.urihttp://hdl.handle.net/10400.17/4965
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherWileypt_PT
dc.subjectHCC CIRpt_PT
dc.subjectCarcinoma, Hepatocellular* / pathologypt_PT
dc.subjectHepatectomypt_PT
dc.subjectHumanspt_PT
dc.subjectLiver Neoplasms* / pathologypt_PT
dc.subjectNeoplasm Stagingpt_PT
dc.subjectPrognosispt_PT
dc.subjectRetrospective Studiespt_PT
dc.subjectalpha-Fetoproteinspt_PT
dc.titleTAC Score Better Predicts Survival Than the BCLC Following Resection of Hepatocellular Carcinomapt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage384pt_PT
oaire.citation.issue3pt_PT
oaire.citation.startPage374pt_PT
oaire.citation.titleJournal of Surgical Oncologypt_PT
oaire.citation.volume127pt_PT
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT

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