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- W2589275903 abstract "231 Background: The Child-Turcotte-Pugh (CTP) score fails to accurately predict survival in hepatocellular carcinoma (HCC), yet remains the standard tool for assessing the liver reserve and guiding therapeutic decisions. CTP relies partially on subjective clinical grading of encephalopathy and ascites. Since liver production of insulin-like growth factor-1 (IGF-1) is significantly reduced in chronic liver diseases and HCC, we hypothesized that IGF-1 could be a valid surrogate for hepatic reserve to replace the subjective parameters in CTP score. Methods: We tested plasma IGF-1 in the training set (n=310). Recursive partitioning identified three optimal IGF-1 ranges that correlated with survival: >50 ng/mL = 1 point; 26-50 ng/mL = 2 points; and <26 ng/mL = 3 points. We modified the CTP score by replacing ascites and encephalopathy with plasma IGF-1, subjected both scores to log-rank analysis, and quantified the prognostic values with C-statistics to compare the scores’ performance. We prospectively validated the score in 150 patients from MDACC; in addition to 180 patients from Korea. Results: The IGF score significantly predicted OS of all classes (p<0·001). In the training cohort, C-indices for CTP and IGF scores were 0·57 and 0·61, respectively (p=0·003 per the U-statistic). Similarly, C-indices in MDACC validation cohort were 0·56 and 0·63 (p=0·02 per the U-statistic), and in Korean cohort were 0·58 and 0·60 (p=0·03 per the U-statistic). Conclusions: The new IGF score is simple and blood-based, and validated well on multiple independent HCC cohorts. It could identify a subpopulation of patients who may benefit from active therapy because of their preserved hepatic reserve, as distinct from patients for whom therapy can be deferred or avoided." @default.
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- W2589275903 date "2014-01-20" @default.
- W2589275903 modified "2023-10-16" @default.
- W2589275903 title "Development and validation of a scoring system using insulin-like growth factor to assess hepatic reserve in hepatocellular carcinoma." @default.
- W2589275903 doi "https://doi.org/10.1200/jco.2014.32.3_suppl.231" @default.
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