Premium
Prediction of long‐term survival by using the Glasgow Prognostic Score in patients with hepatocellular carcinoma after liver transplantation
Author(s) -
Abe Tomoyuki,
Tashiro Hirotaka,
Hattori Minoru,
Kuroda Shintaro,
Tahara Hiroyuki,
Ohira Masahiro,
Kobayashi Tsuyoshi,
Ide Kentaro,
Ishiyama Kohei,
Ohdan Hideki
Publication year - 2016
Publication title -
hepatology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.123
H-Index - 75
eISSN - 1872-034X
pISSN - 1386-6346
DOI - 10.1111/hepr.12597
Subject(s) - medicine , milan criteria , hepatocellular carcinoma , multivariate analysis , univariate analysis , univariate , population , oncology , liver transplantation , multivariate statistics , transplantation , statistics , mathematics , environmental health
Aim This study aimed to validate the prognostic value of the Glasgow Prognostic Score (GPS) in patients who underwent living donor liver transplantation (LDLT) for hepatocellular carcinoma (HCC). Methods Data were retrospectively collected for HCC patients who underwent LDLT. Univariate and multivariate analyses were performed to identify variables associated with overall and recurrence‐free survival. Patients were separated into two groups based on the GPS. The predictive ability of the GPS was compared with other variable scores (modified GPS and hepatic GPS) to identify the most accurate test for this population. Results Univariate analysis identified a GPS of 1 or 2 ( P = 0.018), multiple tumors ( P = 0.032) and HCC beyond the Milan criteria ( P = 0.015) as factors significantly associated with poor overall survival. Hepatitis B negative status ( P = 0.034), a GPS of 1 or 2 ( P = 0.030), α‐fetoprotein of 20.0 ng/mL or more ( P = 0.042) and HCC beyond the Milan criteria ( P = 0.002) were identified as factors significantly associated with poor recurrence‐free survival. Multivariate analysis indicated that HCC beyond the Milan criteria and a GPS of 1 or 2 were independent risk factors for long‐term outcomes. Among the scoring systems evaluated in this study, the GPS was the best predictive system in our population. Moreover, a new scoring system that combined the GPS and the Milan criteria showed the highest prognostic values. Conclusion Novel prediction scores combining the GPS and the Milan criteria provide a precise, objective, and quick approach for selecting appropriate HCC patients for LDLT.