Intermediate-stage hepatocellular carcinoma treated with hepatic resection : the NSP score as an aid to decision-making
Menée à partir de données portant sur 255 patients atteints d'un carcinome hépatocellulaire de stade intermédiaire, puis validée sur 169 patients complémentaires, cette étude chinoise évalue la performance d'un système de score, basé sur trois paramètres clinicopathologiques (nombre de tumeurs, taille maximale des tumeurs et temps de prothrombine), pour identifier les patients pouvant bénéficier d'une résection hépatique
Background : The subgroups of patients with intermediate-stage (BCLC-B) hepatocellular carcinoma (HCC) who would truly benefit from hepatic resection (HR) are unknown. An objective point score was established to guide the selection of these patients for HR.
Methods : In all, 255 consecutive patients with intermediate-stage HCC treated with HR were evaluated retrospectively and included in this study (the training cohort). The variables on overall survival (OS, log-rank test) were investigated and a point score (the NSP score) was developed by using a Cox-regression model and validated in an independent external cohort from another institution (n=169).
Results : The NSP score differentiated two groups of patients (less than or equal to1, >1 point) with distinct prognoses (median OS, 61.3 vs 19.3 months; P<0.001). A high NSP score was associated with increased major adverse events after HR (5.6 vs 13.8%, P=0.027). Its predictive accuracy as determined by the area under the receiver operating characteristic curve (AUC) at 1, 3, and 5 years (AUCs 0.688, 0.739, and 0.732) was greater than the other six staging systems for HCC (0.513–0.677). The findings were supported by the validation cohort.
Conclusions : The NSP scoring system is more accurate in selecting patients with intermediate-stage HCC for HR.
British Journal of Cancer , résumé, 2015