Journal of Clinical and Translational Hepatology

Journal of Clinical and Translational Hepatology

Thursday, 06 / 27 / 2019

Articles

Integration of Prealbumin into Child-Pugh Classification Improves Prognosis Predicting Accuracy in HCC Patients Considering Curative Surgery

ORIGINAL ARTICLE

Integration of Prealbumin into Child-Pugh Classification Improves Prognosis Predicting Accuracy in HCC Patients Considering Curative Surgery

Xiajie Wen1, Mingjie Yao2, Yiwei Lu6, Junhui Chen1, Jiyuan Zhou1, Xiangmei Chen2, Yun Zhang2, Weiquan Lu3, Xiangjun Qian2, Jingmin Zhao4, Ling Zhang*,3, Shigang Ding*,5 and Fengmin Lu*1,2

1Department of Minimally Invasive Intervention, Peking University Shenzhen Hospital, Shenzhen PKU-HKUST Medical Center, Shenzhen, China
2Department of Microbiology & Infectious Disease Center, School of Basic Medical Sciences, Peking University Health Science Center, Beijing, China
3Department of Hepatopancreatobiliary Surgery, Henan Cancer Hospital Affiliated to Zhengzhou University, Zhengzhou, China
4Department of Pathology and Hepatology, Beijing 302 Hospital, Beijing, China
5Peking University Third Hospital, Department of Gastroenterology, Beijing, China
6University of North Carolina - Eshelman School of Pharmacy, Chapel Hill, NC, USA

*Correspondence to: Fengmin Lu, Department of Microbiology & Infectious Disease Center, School of Basic Medical Science, Peking University Health Science Center, Beijing 100191, China. Tel: +86-10-8280-5136, Fax: +86-10-8280-5136, E-mail: This email address is being protected from spambots. You need JavaScript enabled to view it. ; Shigang Ding, Department of Gastroenterology, Peking University Third Hospital, Beijing 100191, China. Tel: +86-15611908241, Fax: +86-10-62017700, E-mail: This email address is being protected from spambots. You need JavaScript enabled to view it. ; Ling Zhang, Department of Hepatopancreatobiliary Surgery, Henan Cancer Hospital Affiliated to Zhengzhou University, Zhengzhou 450001, China. Tel: +86-371-6587787, Fax: +86-371-6587787, E-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.

Journal of Clinical and Translational Hepatology 2018;6(4):377-384 DOI: 10.14218/JCTH.2018.00004
Received: January 8, 2018 Accepted: May 17, 2018 Published online: July 26, 2018

Abstract

Background and Aims: The poor outcomes of hepatocellular carcinoma (HCC) patients may be due to not only malignant tumors but also limited liver function. Therefore, as stated in major guidelines, only patients with relatively normal liver function (Child-Pugh A) would be referred for curative hepatectomy. Even so, the postsurgery survival rate of patients is still extremely poor. Direct curative resection may benefit most patients. This study aimed to improve the prognosis predicting accuracy of the Child-Pugh scoring system.

Methods: This study included two cohorts: cohort A being composed of 613 HCC patients, with a 23-month median postsurgery follow-up time; and cohort B being composed of 554 tumor-free chronic liver disease patients. Kaplan–Meier test and Cox model were used for survival analysis. Independent-samples t test or one-way ANOVA was used to test the differences between different groups.

Results: Serum prealbumin levels were found inversely correlated with worsening of fibrotic scores (r = −0.482, p < 0.001). Lower levels of presurgery prealbumin was an independent factor of poor postsurgery prognosis in Child-Pugh A patients, with a hazard ratio of 0.731 (p = 0.001). By integrating prealbumin together with total bilirubin level, serum albumin concentration and prothrombin time, a modified liver disease prognosis scoring system was developed to define traditional Child-Pugh A HCC patients as Modified Child-Pugh MCP-1, MCP-2 and MCP-3, with median postsurgery overall survival times of 44.00, 28.00 and 11.00 months respectively.

Conclusions: Preoperative serum prealbumin is a valuable prognosis predicting biomarker for Child-Pugh A HCC patients who may be under consideration for curative resection. With serum prealbumin included as one of the parameters, the MCP scoring system might improve the postsurgery survival predicting accuracy for HCC patients.

Keywords

Hepatocellular carcinoma, Curative resection, Survival, Child-Pugh prealbumin

 

 

 

Journal of Clinical and Translational Hepatology 2018 vol. 6, 377-384  [ Html ] [ PDF Full-text ]

 

© The Authors 2018. This article is published under the terms of the Creative Commons Attribution-Noncommercial License (CC BY-NC 4.0), which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license.

 

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