A preoperative model to predict overall survival in patients with hepatoma undergoing resection.

ABSTRACT

BACKGROUND: We aimed to develop a preoperative model to predict overall survival (OS) in patients with hepatoma undergoing liver resection (LR). METHODS: Patients who underwent LR for Barcelona Clinic Liver Cancer (BCLC) stage 0, A, or B hepatoma were enrolled. Tumor burden score (TBS) scores were determined using the following equation TBS (Pinna et al., 2018) 2 = (largest tumor size [in cm])(Pinna et al., 2018) 2 â€‹+ â€‹(tumor number) (Pinna et al., 2018) 22. The cutoff values for radiographic TBS were based on our recently published paper low, <2.6; medium, 2.6-7.9; high, >7.9. RESULTS: Multivariate analysis showed that radiographic TBS (low referent; medium HR â€‹= â€‹2.89; 95 â€‹% CI 1.60-5.21; p â€‹< â€‹0.001; high, HR â€‹= â€‹7.60; 95 â€‹% CI 3.80-15.2; p â€‹< â€‹0.001), AFP (<400 â€‹ng/mL referent; ≧400 â€‹ng/mL HR â€‹= â€‹1.67, 95 â€‹% CI 1.11-2.52, p â€‹= â€‹0.014), and cirrhosis (absence referent; presence HR â€‹= â€‹1.88, 95 â€‹% CI 1.30-2.72, p â€‹< â€‹0.001) were associated with OS. A simplified risk score was superior to BCLC system in concordance index (0.688 vs. 0.623). CONCLUSIONS: We have developed a preoperative model that performs better in predicting OS than the BCLC system.