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KMID : 1188320170110050693
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Gut and Liver
2017 Volume.11 No. 5 p.693 ~ p.701
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Survival Estimates after Stopping Sorafenib in Patients with Hepatocellular Carcinoma: NEXT Score Development and Validation
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Lee Hye-Won
Kim Hyun-Soo
Kim Seung-Up
Kim Beom-Kyung
Park Jun-Yong
Ahn Sang-Hoon
Jeon Mi-Young
Heo Ja-Yoon
Park Soo-Young
Lee Yu-Rim
Jang Sun-Kyung
Lee Su-Hyun
Jang Se-Young
Tak Won-Young
Han Kwang-Hyub
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Abstract
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Background/Aims: Limited information is available regarding patient survival after sorafenib discontinuation in patients with hepatocellular carcinoma (HCC). Thus, we developed and validated a novel survival prediction model.
Methods: Clinical data from 409 patients with HCC who stopped taking sorafenib between September 2008 and February 2015 were reviewed.
Results: In the training cohort, four factors were independent negative predictors of survival (p<0.05). Based on the β regression coefficient of each factor, we established the NEXT score (Survival after Stopping Nexavar Treatment), allocating 1 point each for an Eastern Cooperative Oncology Group score ≥2, Child-Pugh class B or C, serum sodium ≤135 mEq/L, and α-fetoprotein >400 ng/mL. Area under the receiver operating characteristic curve values to predict 1-, 3-, and 6-month survival rates were 0.805, 0.809, and 0.774, respectively, in the training cohort and 0.783, 0.728, and 0.673, respectively, in the validation cohort (n=137). When the training and validation cohorts were stratified into three risk groups (NEXT score 0 [low-risk] vs 1 to 2 [intermediate-risk] vs 3 to 4 [high-risk]), survival differed significantly between the groups (p<0.05, log-rank test).
Conclusions: In patients with HCC, survival after stopping sorafenib is poor. However, risk estimates based on a new “NEXT score” may help predict survival and prognosis even in patients who discontinue sorafenib treatment.
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KEYWORD
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Hepatocellular carcinoma, Survival, Sorafenib, Prediction, Risk
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