Highlights
- •We studied a training set of 370 patients treated with sorafenib for HCC.
- •Variables associated with OS were PS, AFP, tumor size, bilirubin and albumin.
- •We designed a new prognostic model and validated it in a cohort of 468 patients.
- •However, the HAP score was the most discriminant model in the validation cohort.
- •The HAP score could be thus used as a prognostic model in this population.
Abstract
Background
No prognostic classification is currently used for patients treated with systemic
therapies for Hepatocellular Carcinoma (HCC).
Methods
We retrospectively analysed data from patients treated with sorafenib for HCC from
five centres in France and in the United Kingdom (UK). The training set comprised
data from two centres and the validation set from three. Variables independently associated
with Overall Survival (OS) in the training set were used to build the SAP (Sorafenib
Advanced HCC Prognosis) score. The score was tested in the validation set, then compared
with other prognostication systems.
Results
The training set and validation set included 370 and 468 patients respectively. In
the training set, variables independently associated with OS in multivariable analysis
were: performance status (PS) >0, alpha-fetoprotein (AFP) >400 ng/ml, tumour size
>7 cm, bilirubin >17 μmol/l and albumin <36 g/l. The SAP score was built giving one
point to each abnormal variable, and three classes were constructed. The SAP score
was significantly associated with OS in the training set, with median OS of 14.9 months
for SAP A, 7.2 months for SAP B and 2.5 months for SAP C (P < 0.001). In the validation set, the SAP score was significantly associated with
OS, and showed greater discriminative abilities than Barcelona Clinic Liver Cancer
(BCLC) and albumin-bilirubin (ALBI) scores. However, the hepatoma arterial embolisation
prognostic (HAP) score showed greater discriminative abilities than the SAP score.
Conclusion
In European patients treated with sorafenib, the HAP was the most discriminant prognostic
score and may facilitate stratification in trials and inform clinical decision making.
Keywords
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Article info
Publication history
Published online: October 04, 2017
Accepted:
August 30,
2017
Received in revised form:
August 22,
2017
Received:
June 7,
2017
Identification
Copyright
© 2017 Elsevier Ltd. All rights reserved.
