Development and validation of risk score for predicting spontaneous rupture of hepatocellular carcinoma

Feng Ye; Di Ma; Xiao-Yong Gong; Yu-Chen Yang; Yong-Jun Chen

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자료유형: 학술저널

저자정보: Feng Ye (Shanghai Jiaotong University School of Medicine) Di Ma (Shanghai Jiaotong University School of Medicine) Xiao-Yong Gong (Shanghai Jiaotong University School of Medicine) Yu-Chen Yang (Shanghai Jiaotong University School of Medicine) Yong-Jun Chen (Shanghai Jiaotong University School of Medicine)

저널정보: 대한외과학회 Annals of Surgical Treatment and Research Annals of Surgical Treatment and Research Vol.99 No.5

발행연도: 2020.11

수록면: 268 - 274 (7page)

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Purpose: Spontaneous rupture is a potentially serious complication of liver cancer. A risk score was developed and validated for predicting spontaneous rupture based on a retrospective study.
Methods: Multiple logistic regression analysis was used to study the relationship between clinical variables and spontaneous rupture. The independent rupture predictors were converted into a score based on the odds ratio. Predicted attributes of the developed scores were then verified using a dataset in 2019.
Results: The incidence of spontaneous rupture was 5.5% from 2002 to 2019. A 10-point score (α-FP of ≥400 μg/L, 1; protrusion from liver surface, 2; ascites, 3; tumor size of >5 cm, 4) was derived for prediction of rupture and area under the receiver-operating characteristic curve was 0.9 (95% confidence interval, 0.87-0.92). When applying a cutoff value of 5 points or more, the specificity was 0.87 and the sensitivity was 0.84. A validation cohort consisting of 202 hepatocellular carcinoma patients reproduces the predictive, identification, and calibration characteristics. The observed rate of spontaneous rupture according to risk stratification of the score was 0.6% for those with a score of 0-4, 21.6% for a score of 5-7, and 36.4% for a score of 8–10 in the validation cohort.
Conclusion: Here, based on routine clinical data, we determine the factors that affect prognosis and propose an effective tool for predicting spontaneous rupture, which may be useful in guiding priority treatment of high-risk patients or clinical routine preventive treatment.

#Forecasting #Liver cancer #Patient recruitment #Rupture #Scoring methods

참고문헌 (20)

참고문헌 신청

Zhu Q / 2019 / Conditional survival in patients with spontaneous tumor rupture of hepatocellular carcinoma after partial hepatectomy: a propensity score matching analysis / HPB (Oxford) 21:722~730

Sahu SK / 2019 / Rupture of hepatocellular carcinoma : a review of literature / J Clin Exp Hepatol 9:245~256

Jeng KS / 2019 / Liver transplantation after downstagings of ruptured advanced hepatocellular carcinoma in cirrhotic liver : is it advisable? A case report / Transplant Proc 51:1468~1471

Moris D / 2018 / Management, outcomes, and prognostic factors of ruptured hepatocellular carcinoma : a systematic review / J Surg Oncol 117:341~345

Pillai A / 2019 / Liver allocation policies in the USA : past, present, and the future / Dig Dis Sci 64:985~992

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