
Validation and refinement of PROSASH model using the neutrophil‐to‐lymphocyte ratio in patients with HCC receiving sorafenib
Author(s) -
CasadeiGardini Andrea,
Cabibbo Giuseppe,
Dadduzio Vincenzo,
Orsi Giulia,
Vukotic Ranka,
Rizzato Mario Domenico,
Rossi Margherita,
Guarneri Valeria,
Lonardi Sara,
D'Agostino Dario,
Celsa Ciro,
Rovesti Giulia,
Rimini Margherita,
Andreone Pietro,
Zagonel Vittorina,
Scartozzi Mario,
Johnson Philip,
Cascinu Stefano,
Cucchetti Alessandro
Publication year - 2020
Publication title -
liver cancer international
Language(s) - English
Resource type - Journals
ISSN - 2642-3561
DOI - 10.1002/lci2.12
Subject(s) - sorafenib , hepatocellular carcinoma , medicine , neutrophil to lymphocyte ratio , gastroenterology , oncology , lymphocyte , risk stratification , risk model , risk analysis (engineering)
The recently developed PROSASH model is proving to be a useful tool in risk‐group discrimination in hepatocellular carcinoma (HCC) patients treated with sorafenib. Several studies highlighted that the neutrophil‐to‐lymphocyte ratio (NLR) is one of the most important predictors of survival in HCC patients treated with sorafenib. The aims of the present study were to validate the PROSASH model and determine whether the incorporation of inflammatory markers can improve risk stratification. This study included 438 patients. According to the four categories of the PROSASH model, median overall survival (OS) was 20.0, 14.9, 8.5 and 3.0 months respectively ( P < .001). The Harrell's c for this categorized model was 0.621. NLR (cut‐off 3) stratified OS in each of the PROSASH categories. After reclassification, median OS was 21.0, 15.1, 8.2 and 4.1 months ( P < .001). The Harrell's c increased from 0.621 to 0.673 ( P = .001). Integrating NLR into the PROSASH model allowed a more accurate classification of the patients in the risk groups.