http://chineseinput.net/에서 pinyin(병음)방식으로 중국어를 변환할 수 있습니다.
변환된 중국어를 복사하여 사용하시면 됩니다.
( Yeonjung Ha ),( Mohamed A. Mohamed Ali ),( Molly M. Petersen ),( William S. Harmsen ),( Terry M. Therneau ),( Han Chu Lee ),( Baek-yeol Ryoo ),( Sally Bampoh ),( Kenneth A. Valles ),( Mohamad Mady ) 대한간학회 2020 춘·추계 학술대회 (KASL) Vol.2020 No.1
Aims: The ability of the pretreatment lymphocyte to monocyte ratio (LMR) to predict outcomes of patients with hepatocellular carcinoma (HCC) receiving sorafenib is not conclusively determined. Methods: We retrospectively studied patients treated with sorafenib for HCC in two tertiary referral centres in Asia and North America. Primary endpoints were overall survival (OS) and progression-free survival (PFS). Predictive factors for the outcomes were determined by Cox proportional hazards models. A risk-assessment tool was developed. Results: Compared to the North America cohort, the Asia cohort was more heavily pretreated (72.1% vs. 35.2%; P<0.001), had higher hepatitis B virus infection (87.6% vs. 5.6%; P<0.001), and more distant metastases (83.2% vs. 25.4%; P<0.001). Lower monocyte count in the Asia cohort (median, 462.7 vs. 600.0/μL; P=0.023) resulted in a higher LMR (median, 2.6 vs. 1.8; P<0.001). High LMR was associated with a significantly higher OS (hazard ratio [HR], 0.88; 95% confidence interval [CI], 0.81-0.97; P=0.007). This was confirmed in a sensitivity analysis including patients treated in Asia only (HR, 0.89; 95% CI, 0.81-0.97; P=0.010). An OS nomogram was constructed with following variables selected in the multivariate Cox model: LMR, treatment location, previous treatment, performance status, AFP, lymph node metastasis, and Child-Pugh score. The concordance score was 0.71 (95% CI, 0.69-0.73). LMR did not predict PFS. Conclusions: Pretreatment LMR predicts OS in HCC patients treated with sorafenib. Our OS nomogram, incorporating LMR, can be offered to clinicians to improve their ability to assess prognosis, strengthen the prognosis-based decision making, and inform patients in the clinic.
Model to estimate survival in ambulatory patients with hepatocellular carcinoma
Yang, Ju Dong,Kim, W. Ray,Park, Kyung Woo,Chaiteerakij, Roongruedee,Kim, Bohyun,Sanderson, Schuyler O.,Larson, Joseph J.,Pedersen, Rachel A.,Therneau, Terry M.,Gores, Gregory J.,Roberts, Lewis R.,Park Wiley Subscription Services, Inc., A Wiley Company 2012 Hepatology Vol.56 No.2
<P><B>Abstract</B></P><P>Survival of patients with hepatocellular carcinoma (HCC) is determined by the extent of the tumor and the underlying liver function. We aimed to develop a survival model for HCC based on objective parameters including the Model for Endstage Liver Disease (MELD) as a gauge of liver dysfunction. This analysis is based on 477 patients with HCC seen at Mayo Clinic Rochester between 1994 and 2008 (derivation cohort) and 904 patients at the Korean National Cancer Center between 2000 and 2003 (validation cohort). Multivariate proportional hazards models and corresponding risk score were created based on baseline demographic, clinical, and tumor characteristics. Internal and external validation of the model was performed. Discrimination and calibration of this new model were compared against existing models including Barcelona Clinic Liver Cancer (BCLC), Cancer of the Liver Italian Program (CLIP), and Japan Integrated Staging (JIS) scores. The majority of the patients had viral hepatitis as the underlying liver disease (100% in the derivation cohort and 85% in the validation cohort). The survival model incorporated MELD, age, number of tumor nodules, size of the largest nodule, vascular invasion, metastasis, serum albumin, and alpha‐fetoprotein. In cross‐validation, the coefficients remained largely unchanged between iterations. Observed survival in the validation cohort matched closely with what was predicted by the model. The concordance (c)‐statistic for this model (0.77) was superior to that for BCLC (0.71), CLIP (0.70), or JIS (0.70). The score was able to further classify patient survival within each stage of the BCLC classification. <I>Conclusion</I>: A new model to predict survival of HCC patients based on objective parameters provides refined prognostication and supplements the BCLC classification. (H<SMALL>EPATOLOGY</SMALL> 2012)</P>