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Simple models based on gamma-glutamyl transpeptidase and platelets for predicting survival in hepatitis B-associated hepatocellular carcinoma.

Pang Q, Bi JB, Wang ZX, Xu XS, Qu K, Miao RC, Chen W, Zhou YY, Liu C - Onco Targets Ther (2016)

Bottom Line: GPR and S-index were both found to be significantly associated with survival by univariate log-rank test.Multivariate analysis identified tumor size ≥5 and high level of GPR, but not high Barcelona Clinic Liver Cancer stage or S-index, as independent factors for predicting poor overall survival and recurrence-free survival.The GPR is an effective preoperative predictor for outcomes in hepatitis B-associated HCC.

View Article: PubMed Central - PubMed

Affiliation: Department of Hepatobiliary Surgery, the First Affiliated Hospital of Medical College, Xi'an Jiaotong University, Shaanxi Province, People's Republic of China.

ABSTRACT

Background: Several hepatic cirrhosis-derived noninvasive models have been developed to predict the incidence and outcomes of hepatocellular carcinoma (HCC). We aimed to investigate the prognostic significance of the two novel established cirrhosis-associated models based on gamma-glutamyl transpeptidase (GGT) and platelets in hepatitis B-associated HCC.

Methods: We retrospectively evaluated 182 HCC patients with positive hepatitis B surface antigen who received radical therapy at a single institution between 2002 and 2012. Laboratory data prior to operation were collected to calculate the GGT to platelets ratio (GPR) and the S-index. Predictive factors associated with overall survival and recurrence-free survival were assessed using log-rank test and multivariate Cox analysis. Additional analyses were performed after patients were stratified based on cirrhosis status, tumor size, therapy methods, and so forth, to investigate the prognostic significance in different subgroups.

Results: During a median follow-up time of 45.0 months, a total of 88 (48.4%) patients died and 79 (43.4%) patients recurred. The cut-off points for GPR and S-index in predicting death were determined to be 0.76 and 0.56, respectively. Compared with patients with a lower GPR, those with GPR ≥0.76 had a higher probability of cirrhosis and a larger tumor (both P<0.05). GPR and S-index were both found to be significantly associated with survival by univariate log-rank test. Multivariate analysis identified tumor size ≥5 and high level of GPR, but not high Barcelona Clinic Liver Cancer stage or S-index, as independent factors for predicting poor overall survival and recurrence-free survival.

Conclusion: The GPR is an effective preoperative predictor for outcomes in hepatitis B-associated HCC.

No MeSH data available.


Related in: MedlinePlus

Forest plot based on the results of multivariate analysis of the factors associated with overall survival and recurrence-free survival of hepatitis B-related HCC patients.Note: The factors that were found to be significant (P<0.05) in univariate analysis were entered into a multivariate Cox regression models.Abbreviations: AFP, alpha-fetoprotein; AST, aspartate aminotransferase; BCLC, Barcelona Clinic Liver Cancer; CI, confidence interval; GPR, gamma-glutamyl transpeptidase to platelet ratio; HCC, hepatocellular carcinoma; HR, hazard ratio.
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f4-ott-9-2099: Forest plot based on the results of multivariate analysis of the factors associated with overall survival and recurrence-free survival of hepatitis B-related HCC patients.Note: The factors that were found to be significant (P<0.05) in univariate analysis were entered into a multivariate Cox regression models.Abbreviations: AFP, alpha-fetoprotein; AST, aspartate aminotransferase; BCLC, Barcelona Clinic Liver Cancer; CI, confidence interval; GPR, gamma-glutamyl transpeptidase to platelet ratio; HCC, hepatocellular carcinoma; HR, hazard ratio.

Mentions: Univariate analysis showed that aspartate aminotransferase, tumor size, tumor number, vascular invasion, BCLC stage, GPR, and S-index were significantly associated with OS as well as RFS (Table 2). Specifically, patients with a lower level of GPR or S-index had a significantly longer survival than patients with a higher level. Furthermore, multivariate analysis revealed that tumor size and GPR, but not BCLC stage and S-index, were independent predictors of OS and RFS (Figure 4).


Simple models based on gamma-glutamyl transpeptidase and platelets for predicting survival in hepatitis B-associated hepatocellular carcinoma.

Pang Q, Bi JB, Wang ZX, Xu XS, Qu K, Miao RC, Chen W, Zhou YY, Liu C - Onco Targets Ther (2016)

Forest plot based on the results of multivariate analysis of the factors associated with overall survival and recurrence-free survival of hepatitis B-related HCC patients.Note: The factors that were found to be significant (P<0.05) in univariate analysis were entered into a multivariate Cox regression models.Abbreviations: AFP, alpha-fetoprotein; AST, aspartate aminotransferase; BCLC, Barcelona Clinic Liver Cancer; CI, confidence interval; GPR, gamma-glutamyl transpeptidase to platelet ratio; HCC, hepatocellular carcinoma; HR, hazard ratio.
© Copyright Policy
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4835119&req=5

f4-ott-9-2099: Forest plot based on the results of multivariate analysis of the factors associated with overall survival and recurrence-free survival of hepatitis B-related HCC patients.Note: The factors that were found to be significant (P<0.05) in univariate analysis were entered into a multivariate Cox regression models.Abbreviations: AFP, alpha-fetoprotein; AST, aspartate aminotransferase; BCLC, Barcelona Clinic Liver Cancer; CI, confidence interval; GPR, gamma-glutamyl transpeptidase to platelet ratio; HCC, hepatocellular carcinoma; HR, hazard ratio.
Mentions: Univariate analysis showed that aspartate aminotransferase, tumor size, tumor number, vascular invasion, BCLC stage, GPR, and S-index were significantly associated with OS as well as RFS (Table 2). Specifically, patients with a lower level of GPR or S-index had a significantly longer survival than patients with a higher level. Furthermore, multivariate analysis revealed that tumor size and GPR, but not BCLC stage and S-index, were independent predictors of OS and RFS (Figure 4).

Bottom Line: GPR and S-index were both found to be significantly associated with survival by univariate log-rank test.Multivariate analysis identified tumor size ≥5 and high level of GPR, but not high Barcelona Clinic Liver Cancer stage or S-index, as independent factors for predicting poor overall survival and recurrence-free survival.The GPR is an effective preoperative predictor for outcomes in hepatitis B-associated HCC.

View Article: PubMed Central - PubMed

Affiliation: Department of Hepatobiliary Surgery, the First Affiliated Hospital of Medical College, Xi'an Jiaotong University, Shaanxi Province, People's Republic of China.

ABSTRACT

Background: Several hepatic cirrhosis-derived noninvasive models have been developed to predict the incidence and outcomes of hepatocellular carcinoma (HCC). We aimed to investigate the prognostic significance of the two novel established cirrhosis-associated models based on gamma-glutamyl transpeptidase (GGT) and platelets in hepatitis B-associated HCC.

Methods: We retrospectively evaluated 182 HCC patients with positive hepatitis B surface antigen who received radical therapy at a single institution between 2002 and 2012. Laboratory data prior to operation were collected to calculate the GGT to platelets ratio (GPR) and the S-index. Predictive factors associated with overall survival and recurrence-free survival were assessed using log-rank test and multivariate Cox analysis. Additional analyses were performed after patients were stratified based on cirrhosis status, tumor size, therapy methods, and so forth, to investigate the prognostic significance in different subgroups.

Results: During a median follow-up time of 45.0 months, a total of 88 (48.4%) patients died and 79 (43.4%) patients recurred. The cut-off points for GPR and S-index in predicting death were determined to be 0.76 and 0.56, respectively. Compared with patients with a lower GPR, those with GPR ≥0.76 had a higher probability of cirrhosis and a larger tumor (both P<0.05). GPR and S-index were both found to be significantly associated with survival by univariate log-rank test. Multivariate analysis identified tumor size ≥5 and high level of GPR, but not high Barcelona Clinic Liver Cancer stage or S-index, as independent factors for predicting poor overall survival and recurrence-free survival.

Conclusion: The GPR is an effective preoperative predictor for outcomes in hepatitis B-associated HCC.

No MeSH data available.


Related in: MedlinePlus