Development and Validation of Insulin-like Growth Factor-1 Score to Assess Hepatic Reserve in Hepatocellular Carcinoma
| العنوان: | Development and Validation of Insulin-like Growth Factor-1 Score to Assess Hepatic Reserve in Hepatocellular Carcinoma |
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| المؤلفون: | John M. Vierling, Sunil Krishnan, Robert A. Wolff, Prasun Jalal, James L. Abbruzzese, Jeffrey S. Morris, Ahmed Kaseb, Steven A. Curley, Jean Nicolas Vauthey, Claudius Conrad, Hesham M. Hassabo, Thomas A. Aloia, Sheree Cheung, Manal M. Hassan, Young Kwang Chae, Michael J. Wallace, Asif Rashid, Kanwal Pratap Singh Raghav, Lianchun Xiao, Ju Seog Lee |
| المصدر: | JNCI Journal of the National Cancer Institute |
| بيانات النشر: | Oxford University Press, 2014. |
| سنة النشر: | 2014 |
| مصطلحات موضوعية: | Cancer Research, medicine.medical_specialty, Carcinoma, Hepatocellular, viruses, Recursive partitioning, Enzyme-Linked Immunosorbent Assay, Kaplan-Meier Estimate, Gastroenterology, Article, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, Ascites, medicine, Humans, heterocyclic compounds, Insulin-Like Growth Factor I, Proportional Hazards Models, Retrospective Studies, Proportional hazards model, business.industry, Hazard ratio, Liver Neoplasms, Reproducibility of Results, Retrospective cohort study, medicine.disease, Prognosis, Confidence interval, 3. Good health, Surgery, enzymes and coenzymes (carbohydrates), Oncology, Liver, 030220 oncology & carcinogenesis, Hepatocellular carcinoma, 030211 gastroenterology & hepatology, medicine.symptom, business, Cohort study |
| الوصف: | Background Child-Turcotte-Pugh (CTP) score is the standard tool to assess hepatic reserve in hepatocellular carcinoma (HCC), and CTP-A is the classic group for active therapy. However, CTP stratification accuracy has been questioned. We hypothesized that plasma insulin-like growth factor 1 (IGF-1) is a valid surrogate for hepatic reserve to replace the subjective parameters in CTP score to improve its prognostic accuracy. Methods We retrospectively tested plasma IGF-1 levels in the training set (n = 310) from MD Anderson Cancer Center. Recursive partitioning identified three optimal IGF-1 ranges that correlated with overall survival (OS): greater than 50ng/mL = 1 point; 26 to 50ng/mL = 2 points; and less than 26ng/mL = 3 points. We modified the CTP score by replacing ascites and encephalopathy grading with plasma IGF-1 value (IGF-CTP) and subjected both scores to log-rank analysis. Harrell’s C-index and U-statistics were used to compare the prognostic performance of both scores in both the training and validation cohorts (n = 155). All statistical tests were two-sided. Results Patients’ stratification was statistically significantly stronger for IGF-CTP than CTP score for the training (P = .003) and the validation cohort (P = .005). Patients reclassified by IGF-CTP relative to their original CTP score were better stratified by their new risk groups. Most important, patients classified as A by CTP but B by IGF-CTP had statistically significantly worse OS than those who remained under class A by IGF-CTP in both cohorts (P = .03 and P < .001, respectively, from Cox regression models). AB patients had a worse OS than AA patients in both the training and validation set (hazard ratio [HR] = 1.45, 95% confidence interval [CI] = 1.03 to 2.04, P = .03; HR = 2.83, 95% CI = 1.65 to 4.85, P < .001, respectively). Conclusions The IGF-CTP score is simple, blood-based, and cost-effective, stratified HCC better than CTP score, and validated well on two independent cohorts. International validation studies are warranted. |
| اللغة: | English |
| تدمد: | 1460-2105 0027-8874 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::9daa8cb41d93355641caec6008e45960 http://europepmc.org/articles/PMC4085880 |
| Rights: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....9daa8cb41d93355641caec6008e45960 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 14602105 00278874 |
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