Improved survival prediction and comparison of prognostic models for patients with hepatocellular carcinoma treated with sorafenib

Abstract: Background: The ‘Prediction Of Survival in Advanced Sorafenib‐treated HCC’ (PROSASH) model addressed the heterogeneous survival of patients with hepatocellular carcinoma (HCC) treated with sorafenib in clinical trials but requires validation in daily clinical practice. This study aimed to validate, compare and optimize this model for survival prediction.

Methods: Patients treated with sorafenib for HCC at five tertiary European centres were retrospectively staged according to the PROSASH model. In addition, the optimized PROSASH‐II model was developed using the data of four centres (training set) and tested in an independent dataset. These models for overall survival (OS) were then compared with existing prognostic models.
Results

The PROSASH model was validated in 445 patients, showing clear differences between the four risk groups (OS 16.9‐4.6 months). A total of 920 patients (n = 615 in training set, n = 305 in validation set) were available to develop PROSASH‐II. This optimized model incorporated fewer and less subjective parameters: the serum albumin, bilirubin and alpha‐foetoprotein, and macrovascular invasion, extrahepatic spread and largest tumour size on imaging. Both PROSASH and PROSASH‐II showed improved discrimination (C‐index 0.62 and 0.63, respectively) compared with existing prognostic scores (C‐index ≤0.59).
Conclusions

In HCC patients treated with sorafenib, individualized prediction of survival and risk group stratification using baseline prognostic and predictive parameters with the PROSASH model was validated. The refined PROSASH‐II model performed at least as good with fewer and more objective parameters. PROSASH‐II can be used as a tool for tailored treatment of HCC in daily practice and to define pre‐planned subgroups for future studies

Location
Deutsche Nationalbibliothek Frankfurt am Main
Extent
Online-Ressource
Language
Englisch
Notes
Liver international. - 40, 1 (2020) , 215-228, ISSN: 1478-3231

Keyword
Leberzellkrebs
Modell
Prognose
Sorafenib
Überleben

Event
Veröffentlichung
(where)
Freiburg
(who)
Universität
(when)
2020
Creator
Labeur, Tim A.
Berhane, Sarah
Edeline, Julien
Blanc, Jean‐Frederic
Bettinger, Dominik
Meyer, Tim
Vugt, Jeroen L. A. Van
Ten Cate, David W. G.
Man, Robert de
Eskens, Ferry A. L. M.
Cucchetti, Alessandro
Bonnett, Laura J.
Van Delden, Otto M.
Klümpen, Heinz‐Josef
Takkenberg, R. Bart
Johnson, Philip J.

DOI
10.1111/liv.14270
URN
urn:nbn:de:bsz:25-freidok-1552771
Rights
Der Zugriff auf das Objekt ist unbeschränkt möglich.
Last update
25.03.2025, 1:49 PM CET

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Associated

  • Labeur, Tim A.
  • Berhane, Sarah
  • Edeline, Julien
  • Blanc, Jean‐Frederic
  • Bettinger, Dominik
  • Meyer, Tim
  • Vugt, Jeroen L. A. Van
  • Ten Cate, David W. G.
  • Man, Robert de
  • Eskens, Ferry A. L. M.
  • Cucchetti, Alessandro
  • Bonnett, Laura J.
  • Van Delden, Otto M.
  • Klümpen, Heinz‐Josef
  • Takkenberg, R. Bart
  • Johnson, Philip J.
  • Universität

Time of origin

  • 2020

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