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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

Cumulative overall survival (A) and recurrence-free survival (B) curves of the subgroup study stratification of patients according to GPR and tumor size.Notes: Group A (GPR <0.76 and tumor size <5 cm), Group B (GPR <0.76 but tumor size ≥5 cm, or tumor size <5 cm but GPR ≥0.76), and Group C (GPR ≥0.76 and tumor size ≥5 cm). The P-values were calculated by log-rank test.Abbreviation: GPR, gamma-glutamyl transpeptidase to platelet ratio.
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f6-ott-9-2099: Cumulative overall survival (A) and recurrence-free survival (B) curves of the subgroup study stratification of patients according to GPR and tumor size.Notes: Group A (GPR <0.76 and tumor size <5 cm), Group B (GPR <0.76 but tumor size ≥5 cm, or tumor size <5 cm but GPR ≥0.76), and Group C (GPR ≥0.76 and tumor size ≥5 cm). The P-values were calculated by log-rank test.Abbreviation: GPR, gamma-glutamyl transpeptidase to platelet ratio.

Mentions: The 1-, 3-, and 5-year OS rates were 92.2%, 79.7%, and 73.1% versus 74.6%, 55.6%, and 40.3% versus 55.6%, 33.5%, and 25.1% for groups A, B, and C, respectively (P<0.001) (Figure 6A). Similarly, Group A showed significantly higher RFS rates compared with groups B or C (P<0.001) (Figure 6B).


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)

Cumulative overall survival (A) and recurrence-free survival (B) curves of the subgroup study stratification of patients according to GPR and tumor size.Notes: Group A (GPR <0.76 and tumor size <5 cm), Group B (GPR <0.76 but tumor size ≥5 cm, or tumor size <5 cm but GPR ≥0.76), and Group C (GPR ≥0.76 and tumor size ≥5 cm). The P-values were calculated by log-rank test.Abbreviation: GPR, gamma-glutamyl transpeptidase to platelet ratio.
© Copyright Policy
Related In: Results  -  Collection

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

f6-ott-9-2099: Cumulative overall survival (A) and recurrence-free survival (B) curves of the subgroup study stratification of patients according to GPR and tumor size.Notes: Group A (GPR <0.76 and tumor size <5 cm), Group B (GPR <0.76 but tumor size ≥5 cm, or tumor size <5 cm but GPR ≥0.76), and Group C (GPR ≥0.76 and tumor size ≥5 cm). The P-values were calculated by log-rank test.Abbreviation: GPR, gamma-glutamyl transpeptidase to platelet ratio.
Mentions: The 1-, 3-, and 5-year OS rates were 92.2%, 79.7%, and 73.1% versus 74.6%, 55.6%, and 40.3% versus 55.6%, 33.5%, and 25.1% for groups A, B, and C, respectively (P<0.001) (Figure 6A). Similarly, Group A showed significantly higher RFS rates compared with groups B or C (P<0.001) (Figure 6B).

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