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NIACE score refines the overall survival of hepatocellular carcinoma by Barcelona clinic liver cancer staging
Author(s) -
Su TungHung,
Liao SihHan,
Hong ChunMing,
Liu ChunJen,
Tseng TaiChung,
Liu ChenHua,
Yang HungChih,
Chen PeiJer,
Chen DingShinn,
Chen ChiLing,
Adhoute Xavier,
Bourlière Marc,
Kao JiaHorng
Publication year - 2019
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/jgh.14705
Subject(s) - medicine , hepatocellular carcinoma , hazard ratio , liver cancer , confidence interval , gastroenterology , confounding , proportional hazards model , log rank test , carcinoma
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.