Development and Validation of a New Prognostic System for Patients with Hepatocellular Carcinoma
- Fabio Farinati 1, Alessandro Vitale 1, Gaya Spolverato 1, Timothy M Pawlik 2, Teh-la Huo 3,4, Yun-Hsuan Lee 3,4, Anna Chiara Frigo 5, Anna Giacomin 1, Edoardo G Giannini 6, Francesca Ciccarese 7, Fabio Piscaglia 8, Gian Lodovico Rapaccini 9, Mariella Di Marco 10, Eugenio Caturelli 11, Marco Zoli 8, Franco Borzio 12, Giuseppe Cabibbo 13, Martina Felder 14, Rodolfo Sacco 15, Filomena Morisco 16, Elisabetta Biasini 17, Francesco Giuseppe Foschi 18, Antonio Gasbarrini 19, Gianluca Svegliati Baroni 20, Roberto Virdone 21, Alberto Masotto 22, Franco Trevisani 23, Umberto Cillo 1,
- 1Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy.
- 2Department of Surgery, Johns Hopkins Hospital, Baltimore, Maryland, United States of America.
- 3National Yang-Ming University, Taipei City, Taiwan.
- 4Department of Medicine, Taipei Veterans General Hospital, Taipei City, Taiwan.
- 5Biostatistics Unit, University of Padua, Padua, Italy.
- 6Gastroenterology Unit, Department of Internal Medicine, IRCCS Azienda Ospedaliera Universitaria San Martino IST, University of Genoa, Genoa, Italy.
- 7Division of Surgery, San Marco Hospital, Zingonia, Italy.
- 8Division of Internal Medicine, Department of Medical and Surgical Sciences, Alma Mater Studiorum, University of Bologna, Bologna, Italy.
- 9Division of Internal Medicine and Gastroenterology, Complesso Integrato Columbus, Università Cattolica del Sacro Cuore, Rome, Italy.
- 10Division of Medicine, Bolognini Hospital, Seriate, Italy.
- 11Division of Gastroenterology, Belcolle Hospital, Viterbo, Italy.
- 12Division of Radiology, Department of Medicine, Fatebenefratelli Hospital, Milan, Italy.
- 13Division of Gastroenterology, Biomedical Department of Internal and Specialistic Medicine, University of Palermo, Palermo, Italy.
- 14Division of Gastroenterology, Bolzano Regional Hospital, Bolzano, Italy.
- 15Division of Gastroenterology and Metabolic Diseases, University Hospital of Pisa, Pisa, Italy.
- 16Division of Gastroenterology, Department of Medicine and Surgery, University of Naples Federico II, Naples, Italy.
- 17Division of Infectious Diseases and Hepatology, Azienda Ospedaliero-Universitaria di Parma, Parma, Italy.
- 18Department of Internal Medicine, Ospedale per gli Infermi di Faenza, Faenza, Italy.
- 19Division of Internal Medicine and Gastroenterology, Fondazione Policlinico Universitario A. Gemelli, Università Cattolica del Sacro Cuore, Roma, Italy.
- 20Division of Gastroenterology, Polytechnic University of Marche, Ancona, Italy.
- 21Division of Internal Medicine 2, Ospedali Riuniti Villa Sofia Cervello, Palermo, Italy.
- 22Gastroenterology Unit, Ospedale Sacro Cuore Don Calabria, Negrar, Italy.
- 23Division of Semeiotics, Department of Medical and Surgical Sciences, Alma Mater Studiorum, University of Bologna, Bologna, Italy.
- 0Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy.
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View abstract on PubMed
Summary
This summary is machine-generated.A new hepatocellular carcinoma (HCC) prognostic system, the ITA.LI.CA score, was developed and validated. This system accurately predicts individual survival in HCC patients across European and Asian populations, outperforming existing models.
Area Of Science
- Hepatology
- Oncology
- Medical Informatics
Background
- Prognostic assessment for hepatocellular carcinoma (HCC) is challenging and lacks consensus.
- Existing models for HCC prognosis require refinement for improved accuracy.
Purpose Of The Study
- To develop and validate a novel prognostic system for HCC patients.
- To create a system that integrates tumor characteristics and clinical factors for individual survival prediction.
Main Methods
- Utilized prospective data from Italy (training/internal validation) and Taiwan (external validation).
- Developed the ITA.LI.CA staging system based on tumor characteristics (size, number, invasion, metastasis).
- Constructed an integrated prognostic score using tumor stage, ECOG, Child-Pugh score, and AFP via a survival model.
Main Results
- The ITA.LI.CA prognostic score demonstrated excellent discrimination and calibration in both Italian and Taiwanese cohorts.
- The score showed significantly better prognostic ability (C-index 0.71-0.78) compared to BCLC, CLIP, JIS, MESIAH, and HKLC systems.
- Observed and predicted survival largely coincided, indicating the model's reliability across diverse populations.
Conclusions
- The ITA.LI.CA prognostic system, comprising tumor staging and an integrated score, provides a robust tool for predicting HCC patient survival.
- This system effectively stratifies patients and integrates key clinical and tumor factors.
- The ITA.LI.CA system shows strong predictive power in both European and Asian populations.
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