接受手术或经动脉化疗栓塞治疗的肝细胞癌患者的NIACE评分。
NIACE score for hepatocellular carcinoma patients treated by surgery or transarterial chemoembolization.
作者信息
Adhoute Xavier, Pénaranda Guillaume, Raoul Jean Luc, Bollon Emilie, Pol Bernard, Letreut Yves P, Perrier Hervé, Bayle Olivier, Monnet Olivier, Beaurain Patrick, Muller Cyril, Hardwigsen Jean, Lefolgoc Gaëlle, Castellani Paul, Bronowicki Jean P, Bourlière Marc
机构信息
aDepartment of Hepato-Gastroenterology bDepartment of Hepatobiliary Surgery cDepartment of Radiology, Hôpital Saint-Joseph dAlphaBio Laboratory eDepartment of Hepato-Gastroenterology and Digestive Oncology, Institut Paoli-Calmette fDepartment of Hepatobiliary Surgery, Centre Hospitalo-Universitaire Timone, Marseille gDepartment of Hepato-Gastroenterology, Centre Hospitalo-Universitaire de Nancy hINSERM U954, Université de Lorraine, CHU de Nancy, Vandoeuvre les Nancy, France.
出版信息
Eur J Gastroenterol Hepatol. 2017 Jun;29(6):706-715. doi: 10.1097/MEG.0000000000000852.
BACKGROUND AND AIMS
Hepatocellular carcinoma (HCC) prognostic scores could be useful in addition to the Barcelona Clinic Liver Cancer (BCLC) system to clarify patient prognosis and guide treatment decision. The NIACE (tumor Nodularity, Infiltrative nature of the tumor, serum Alpha-fetoprotein level, Child-Pugh stage, ECOG performance status) score distinguishes different prognosis groups among BCLC A, B, and C HCC patients. Our aims are to evaluate the NIACE score and its additive value in two HCC cohorts treated either by surgery or by chemoembolization, and then according to the BCLC recommendations.
PATIENTS AND METHODS
This was a retrospective multicenter study with two BCLC A, B, and C HCC cohorts treated either by surgery (n=207) or by chemoembolization (n=168) carried out between 2008 and 2013. We studied survival time according to the baseline NIACE score and compared it with the Cancer of the Liver Italian Program score and the BCLC system.
RESULTS
The NIACE score differentiates between subgroups of patients with different prognosis within each BCLC class. Among BCLC A patients treated by surgery and BCLC B patients treated by chemoembolization, the NIACE score differentiates between two subgroups with a significant difference in survival time: 68 (55-81) months versus 35 (21-56) months (P=0.0004) and 20 (17-24) months versus 13 (7-17) months (P=0.0008), respectively. Among those subgroups, the NIACE score has a significantly better prognostic value than the BCLC system or the Cancer of the Liver Italian Program score.
CONCLUSION
In this study, among HCC patients treated according to the BCLC recommendations, the NIACE score predicts more accurately than any other system the survival time.
背景与目的
除巴塞罗那临床肝癌（BCLC）系统外，肝细胞癌（HCC）预后评分有助于明确患者预后并指导治疗决策。NIACE（肿瘤结节性、肿瘤浸润性、血清甲胎蛋白水平、Child-Pugh分期、美国东部肿瘤协作组体能状态）评分可区分BCLC A、B和C期HCC患者的不同预后组。我们的目的是评估NIACE评分及其在两个分别接受手术或化疗栓塞治疗的HCC队列中的附加价值，然后根据BCLC建议进行评估。
患者与方法
这是一项回顾性多中心研究，纳入了2008年至2013年间接受手术治疗（n=207）或化疗栓塞治疗（n=168）的两个BCLC A、B和C期HCC队列。我们根据基线NIACE评分研究生存时间，并将其与意大利肝癌项目评分和BCLC系统进行比较。
结果
NIACE评分可区分每个BCLC类别中不同预后的患者亚组。在接受手术治疗的BCLC A期患者和接受化疗栓塞治疗的BCLC B期患者中，NIACE评分区分出两个生存时间有显著差异的亚组：分别为68（55 - 81）个月对35（21 - 56）个月（P=0.0004）和20（17 - 24）个月对13（7 - 17）个月（P=0.0008）。在这些亚组中，NIACE评分的预后价值明显优于BCLC系统或意大利肝癌项目评分。
结论
在本研究中，在根据BCLC建议治疗的HCC患者中，NIACE评分比任何其他系统更准确地预测生存时间。
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