NIACE score refines the overall survival of hepatocellular carcinoma by Barcelona clinic liver cancer staging
Tung-Hung Su
Division of Gastroenterology and Hepatology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
Department of Internal Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
Hepatitis Research Center, National Taiwan University Hospital, Taipei, Taiwan
Search for more papers by this authorSih-Han Liao
Division of Gastroenterology and Hepatology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
National Taiwan University Cancer Center, Taipei, Taiwan
Search for more papers by this authorChun-Ming Hong
Division of Hospital Medicine, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
Search for more papers by this authorChun-Jen Liu
Division of Gastroenterology and Hepatology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
Department of Internal Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
Hepatitis Research Center, National Taiwan University Hospital, Taipei, Taiwan
Search for more papers by this authorTai-Chung Tseng
Division of Gastroenterology and Hepatology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
Hepatitis Research Center, National Taiwan University Hospital, Taipei, Taiwan
Search for more papers by this authorChen-Hua Liu
Division of Gastroenterology and Hepatology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
Department of Internal Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
Hepatitis Research Center, National Taiwan University Hospital, Taipei, Taiwan
Search for more papers by this authorHung-Chih Yang
Division of Gastroenterology and Hepatology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
Search for more papers by this authorPei-Jer Chen
Division of Gastroenterology and Hepatology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
Hepatitis Research Center, National Taiwan University Hospital, Taipei, Taiwan
Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
Search for more papers by this authorDing-Shinn Chen
Division of Gastroenterology and Hepatology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
Hepatitis Research Center, National Taiwan University Hospital, Taipei, Taiwan
Search for more papers by this authorChi-Ling Chen
Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
Search for more papers by this authorXavier Adhoute
Department of Hepato-Gastroenterology, Hôpital Saint Joseph, Marseille, France
Search for more papers by this authorMarc Bourlière
Department of Hepato-Gastroenterology, Hôpital Saint Joseph, Marseille, France
Search for more papers by this authorCorresponding Author
Jia-Horng Kao
Division of Gastroenterology and Hepatology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
Hepatitis Research Center, National Taiwan University Hospital, Taipei, Taiwan
Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
Correspondence
Professor Jia-Horng Kao, Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, 1 Chang-Te Street, Taipei 10048, Taiwan.
Email: [email protected]
Search for more papers by this authorTung-Hung Su
Division of Gastroenterology and Hepatology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
Department of Internal Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
Hepatitis Research Center, National Taiwan University Hospital, Taipei, Taiwan
Search for more papers by this authorSih-Han Liao
Division of Gastroenterology and Hepatology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
National Taiwan University Cancer Center, Taipei, Taiwan
Search for more papers by this authorChun-Ming Hong
Division of Hospital Medicine, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
Search for more papers by this authorChun-Jen Liu
Division of Gastroenterology and Hepatology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
Department of Internal Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
Hepatitis Research Center, National Taiwan University Hospital, Taipei, Taiwan
Search for more papers by this authorTai-Chung Tseng
Division of Gastroenterology and Hepatology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
Hepatitis Research Center, National Taiwan University Hospital, Taipei, Taiwan
Search for more papers by this authorChen-Hua Liu
Division of Gastroenterology and Hepatology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
Department of Internal Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
Hepatitis Research Center, National Taiwan University Hospital, Taipei, Taiwan
Search for more papers by this authorHung-Chih Yang
Division of Gastroenterology and Hepatology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
Search for more papers by this authorPei-Jer Chen
Division of Gastroenterology and Hepatology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
Hepatitis Research Center, National Taiwan University Hospital, Taipei, Taiwan
Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
Search for more papers by this authorDing-Shinn Chen
Division of Gastroenterology and Hepatology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
Hepatitis Research Center, National Taiwan University Hospital, Taipei, Taiwan
Search for more papers by this authorChi-Ling Chen
Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
Search for more papers by this authorXavier Adhoute
Department of Hepato-Gastroenterology, Hôpital Saint Joseph, Marseille, France
Search for more papers by this authorMarc Bourlière
Department of Hepato-Gastroenterology, Hôpital Saint Joseph, Marseille, France
Search for more papers by this authorCorresponding Author
Jia-Horng Kao
Division of Gastroenterology and Hepatology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
Hepatitis Research Center, National Taiwan University Hospital, Taipei, Taiwan
Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
Correspondence
Professor Jia-Horng Kao, Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, 1 Chang-Te Street, Taipei 10048, Taiwan.
Email: [email protected]
Search for more papers by this authorAbstract
Background and Aim
The NIACE score provides prognostic values for hepatocellular carcinoma (HCC) in European studies. We aim to evaluate the prognostic value of the NIACE score in Asian patients.
Methods
Patients with HCC were retrospectively enrolled from a tertiary medical center in Taiwan during 2009–2014, and their clinical information were collected. The NIACE score was calculated according to the Nodular numbers, tumor Infiltration, Alpha-fetoprotein level, Child–Pugh score, and Eastern Cooperative Oncology Group score. The prognostic values of NIACE score for overall survival according to individual treatment and the Barcelona clinic liver cancer (BCLC) staging were analyzed.
Results
A total of 468 patients were included with a median follow-up of 30 months. A greater NIACE score correlated with lower median survival and higher BCLC staging. Regardless of treatment modalities, NIACE scores (0, 1–1.5, 2.5–3, and 4–7) significantly predicted survival between groups (log–rank P < 0.001). Specifically, NIACE score (0, 1–1.5, 2.5–3, and 4–7) significantly predicted survival in patients receiving transarterial chemoembolization (log–rank P < 0.001). NIACE score 1, 2.5, and 4 further distinguished overall survival in BCLC A, B, and C patients, respectively (all log–rank P < 0.01). After adjustment of the confounders and the BCLC staging, NIACE score of 2.5–3 and 4–7 (vs 0) had a significantly increased risk of mortality with a hazard ratio of 4.04 (95% confidence interval: 2.14–7.64, P < 0.001) and 7.45 (95% confidence interval: 3.22–17.23, P < 0.001), respectively.
Conclusions
The NIACE score helps refine differential prognosis among BCLC A, B, and C subgroups of Asian patients with HCC, especially in those receiving transarterial chemoembolization.
Supporting Information
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Table S1. The calculation of NIACE score. Table S2. The staging and treatment modality of patients with hepatocellular carcinoma. Table S3. The NIACE score independently predicts all-cause mortality of hepatocellular carcinoma in patients with chronic hepatitis B or C (n=359). Figure S1. The overall survival of patients with hepatocellular carcinoma according to NIACE score (0, 1-1.5, 2.5-3, and 4-7) with treatment by the BCLC guideline (A), or beyond the BCLC guideline (B). Figure S2. The overall survival of patients with hepatocellular carcinoma according to individual Barcelona clinic liver cancer (BCLC) staging in patients receiving (A) surgery, (B) radiofrequency ablation (RFA), (C) transarterial chemoembolization (TACE), and (D) systemic therapy. Figure S3. The overall survival of patients with hepatocellular carcinoma according to the NIACE scores in patients receiving (A) surgery, (B) radiofrequency ablation (RFA), (C) transarterial chemoembolization (TACE), and (D) systemic therapy by the Barcelona clinic liver cancer (BCLC) guideline. Figure S4. The overall survival of patients with hepatocellular carcinoma according to the NIACE scores in patients receiving (A) surgery, (B) radiofrequency ablation (RFA), and (C) transarterial chemoembolization (TACE) beyond the Barcelona clinic liver cancer (BCLC) guideline. |
Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
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