A new prognostic model for hepatocellular carcinoma recurrence after curative hepatectomy

Tokumitsu,Yukio; Sakamoto,Kazuhiko; Tokuhisa,Yoshihiro; Matsui,Hiroto; Matsukuma,Satoshi; Maeda,Yoshinari; Sakata,Koichiro; Wada,Hiroshi; Eguchi,Hidetoshi; Ogihara,Hiroyuki; Fujita,Yusuke; Hamamoto,Yoshihiko; Iizuka,Norio; Ueno,Tomio; Nagano,Hiroaki

doi:10.3892/ol.2018.7821

A new prognostic model for hepatocellular carcinoma recurrence after curative hepatectomy

Authors:
- Yukio Tokumitsu
- Kazuhiko Sakamoto
- Yoshihiro Tokuhisa
- Hiroto Matsui
- Satoshi Matsukuma
- Yoshinari Maeda
- Koichiro Sakata
- Hiroshi Wada
- Hidetoshi Eguchi
- Hiroyuki Ogihara
- Yusuke Fujita
- Yoshihiko Hamamoto
- Norio Iizuka
- Tomio Ueno
- Hiroaki Nagano
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Affiliations: Department of Gastroenterological, Breast and Endocrine Surgery, Yamaguchi University Graduate School of Medicine, Ube, Yamaguchi 755‑8505, Japan, Department of Surgery, Kanmon Medical Center, National Hospital Organization, Shimonoseki, Yamaguchi 752‑8510, Japan, Department of Surgery, Shimonoseki Medical Center, Japan Community Health Care Organization, Shimonoseki, Yamaguchi 750‑0061, Japan, Department of Gastroenterological Surgery, Osaka University Graduate School of Medicine, Suita, Osaka 565‑0871, Japan, Department of Biomolecular Engineering Applied Molecular Bioscience, Yamaguchi University Graduate School of Medicine, Ube, Yamaguchi 755‑8611, Japan, Department of Information Science and Engineering, Yamaguchi University Graduate School of Sciences and Technology for Innovation, Ube, Yamaguchi 755‑8611, Japan, Department of Kampo Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima 734‑8553, Japan, Department of Digestive Surgery, Kawasaki Medical School, Kurashiki, Okayama 701‑0192, Japan
Published online on: January 19, 2018 https://doi.org/10.3892/ol.2018.7821
Pages: 4411-4422

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Abstract

We previously reported the effectiveness of the product of tumor number and size (NxS factor) for the prognosis of hepatocellular carcinoma (HCC) in patients following hepatectomy. The present study aimed to propose a new score based on the NxS factor to predict HCC recurrence following hepatectomy. A total of 406 patients who underwent hepatectomy for HCC at Osaka University Graduate School of Medicine were retrospectively analyzed to develop the new score. Among clinicopathological factors, including the NxS factor, the marker subset that achieved the best performance for prediction of early recurrence was assessed, and a prognostic model for HCC recurrence after curative hepatectomy (REACH) was developed. As the validation set, 425 patients who underwent hepatectomy for HCC at Yamaguchi University Graduate School of Medicine and Shimonoseki Medical Center were analyzed, and the prognostic ability of the REACH score was compared with that of well‑known staging systems. Following analysis, the REACH score was constructed using six covariates (NxS factor, microscopic hepatic vein invasion, differentiation, serum albumin, platelet count and indocyanine green retention rate at 15 min). In the validation set, the REACH score predicted early recurrence in 73 of 81 samples, with a sensitivity of 89% and a specificity of 58%. The area under the curve (AUC) of the receiver operating characteristic curve of the REACH score was 0.78 and 0.74, respectively, for 1‑ and 2‑year recurrence after hepatectomy; each AUC was higher than that of any of the other staging systems. Survival analysis indicated the REACH score had the best predictive value in disease‑free and overall survival. The present findings demonstrated that the REACH score may be used to classify patients with HCC into high‑ and low‑risk of recurrence, and to predict subsequent survival following hepatic resection.

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