Wang ZX, Li J, Wang EX, Xia DD, Bai W, Wang QH, Yuan J, Li XM, Niu J, Yin ZX, Xia JL, Fan DM, Han GH. Validation of the six-and-twelve criteria among patients with hepatocellular carcinoma and performance score 1 receiving transarterial chemoembolization. World J Gastroenterol 2020; 26(15): 1805-1819 [PMID: 32351295 DOI: 10.3748/wjg.v26.i15.1805]
Corresponding Author of This Article
Guo-Hong Han, MD, PhD, Professor, Department of Liver Disease and Digestive Interventional Radiology, National Clinical Research Center for Digestive Diseases and Xijing Hospital of Digestive Diseases, Fourth Military Medical University, 15 West Changle Road, Xi’an 710032, Shaanxi Province, China. hangh@fmmu.edu.cn
Research Domain of This Article
Oncology
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastroenterol. Apr 21, 2020; 26(15): 1805-1819 Published online Apr 21, 2020. doi: 10.3748/wjg.v26.i15.1805
Table 1 Baseline characteristic for the cohort, n = 792
Characteristics
Values
Age at start, yr, mean ± SD
56.4 ± 11.6
Gender, men/women, n (%)
663 (83.7)/129 (16.3)
Etiology, HBV/non-HBV, n (%)
681 (86.0)/111 (14.0)
Child-Pugh class, A/B, n (%)
742 (93.7)/50 (6.3)
ALBI grade, 1/2/3, n (%)
323 (40.8)/458 (57.8)/11 (1.4)
Tumor size, cm, mean ± SD/median (IQR)
8.6 ± 4.1/8.2 (5.2-11.5)
Tumor number, mean ± SD/median (IQR)
2.4 ± 2.2/1 (1-3)
AFP, ≤ 400/> 400 ng/mL/NA, n (%)
431 (54.4)/337 (42.6)/24 (3.0)
White blood cell, 109/L, mean ± SD
5.8 ± 2.6
Red blood cell, 106/L, mean ± SD
4.4 ± 0.7
Platelets, 109/L, mean ± SD
158.4 ± 88.9
International normalized ratio, mean ± SD
1.08 ± 0.12
Alanine aminotransferase, U/L, mean ± SD
53.0 ± 47.3
Aspartate aminotransferase, U/L, mean ± SD
67.5 ± 59.6
Albumin, g/L, mean ± SD
38.7 ± 7.0
Total bilirubin, μmol/L, mean ± SD
18.1 ± 8.5
Urea nitrogen, mmol/L, mean ± SD
5.5 ± 3.1
Serum creatinine, μmol/L, mean ± SD
71.9 ± 20.7
Sessions of TACE, mean ± SD/ median (IQR)
2.9 ± 2.0/2 (1-4)
Table 2 Univariate analyses for overall survival
Characteristics
HR (95%CI)
P value
Gender, male (Ref: Female)
0.84 (0.66-1.08)
0.167
Age, per yr increase
1.00 (0.99-1.01)
0.429
Etiology Others (Ref: HBV)
0.79 (0.61-1.04)
0.092
Tumor size, per 1 cm increase
1.10 (1.08-1.13)
< 0.001
Tumor number, per 1 lesion increase
1.11 (1.07-1.15)
< 0.001
Child-Pugh class B (Ref: A)
1.41 (1.00-1.98)
0.047
ALBI grade 2 (Ref: 1)
1.35 (1.14-1.61)
0.001
AFP > 400 ng/mL (Ref: ≤ 400 ng/mL)
1.51 (1.26-1.81)
< 0.001
White blood cell, per 1 109/L increase
1.07 (1.04-1.10)
< 0.001
Red blood cell, per 1 106/L increase
0.87 (0.74-1.03)
0.098
Platelets, per 1 109/L increase
1.00 (1.00-1.00)
< 0.001
International normalized ratio, per 1% increase
0.96 (0.46-1.99)
0.903
Alanine aminotransferase, per 1 U/L increase
1.00 (1.00-1.00)
0.606
Aspartate aminotransferase, per 1 U/L increase
1.00 (1.00-1.01)
0.011
Total bilirubin, per 1 μmol/L increase
1.02 (1.01-1.03)
0.004
Albumin, per 1 g/L increase
0.99 (0.98-1.01)
0.200
ALBI score, per 1 score increase
1.18 (0.99-1.40)
0.062
Blood urea nitrogen, per 1 mmol/L increase
0.98 (0.94-1.02)
< 0.315
Creatinine, per 1 μmol/L increase
1.01 (1.00-1.01)
0.881
Table 3 Multivariate analyses for overall survival
Characteristics
Model 1
Model 2
Model 3
HR (95%CI)
P value
HR (95%CI)
P value
HR (95%CI)
P value
Tumor size, per 1 cm increase
1.10 (1.08-1.12)
< 0.001
1.10 (1.08-1.12)
< 0.001
1.10 (1.07-1.12)
< 0.001
Tumor number, per 1 lesion increase
1.10 (1.07-1.14)
< 0.001
1.10 (1.06-1.64)
< 0.001
1.11 (1.07-1.15)
< 0.001
AFP > 400 ng/mL (Ref: ≤ 400 ng/mL)
1.31 (1.09-1.98)
0.047
1.36 (1.13-1.63)
0.001
1.28 (1.06-1.53)
0.010
Child-Pugh class B (Ref: A)
ALBI grade 2 (Ref: 1)
1.44 (1.20-1.72)
< 0.001
Total bilirubin, per 1 μmol/L increase
1.01 (1.00-1.02)
0.025
Table 4 Comparison of the performance and discriminating abilities of the proposed models and six-and-twelve criteria
Prognostic models
AUROC (95%CI)
LR χ2
df
C-index (95%CI)
R2
1-yr
2-yr
3-yr
Model 1
0.72 (0.68-0.76)
0.69 (0.65-0.74)
0.66 (0.60-0.71)
98.4
3
0.65 (0.63-0.68)
0.117
LP = TS + TN + 2.9 × AFP
Model 2
0.72 (0.68-0.76)
0.69 (0.56-0.73)
0.67 (0.61-0.72)
101.4
4
0.66 (0.64-0.69)
0.120
LP = TS + TN + 3.2 × AFP + 3.8 × ALBI
Model 3
0.74 (0.71-0.78)
0.72 (0.68-0.76)
0.68 (0.63-0.74)
124.3
4
0.67 (0.65-0.70)
0.149
LP = TS + 1.1 × TN + 2.7 × AFP + 0.1 × TBIL
Six-and-twelve criteria
0.74 (0.70-0.77)
0.71 (0.67-0.75)
0.68 (0.63-0.74)
114.3
2
0.67 (0.64-0.69)
0.134
LP = TS + TN
Citation: Wang ZX, Li J, Wang EX, Xia DD, Bai W, Wang QH, Yuan J, Li XM, Niu J, Yin ZX, Xia JL, Fan DM, Han GH. Validation of the six-and-twelve criteria among patients with hepatocellular carcinoma and performance score 1 receiving transarterial chemoembolization. World J Gastroenterol 2020; 26(15): 1805-1819