Value of the model for end-stage liver disease for predicting survival in hepatocellular carcinoma patients treated with transarterial chemoembolization

Jeong Han Kim, Ji Hoon Kim, Jong Hwan Choi, Chung Ho Kim, Young Kul Jung, Hyung Joon Yim, Jong Eun Yeon, Jong Jae Park, Jae Seon Kim, Young-Tae Bak, Kwan Soo Byun

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Abstract

Objective. The aim of this study was to evaluate the prognostic value of the model for end-stage liver disease (MELD) and its modified forms, and to compare these scoring systems with other staging systems for hepatocellular carcinoma (HCC) patients treated with transarterial chemoembolization (TACE). Material and methods. A total of 325 patients who underwent TACE for the initial treatment of HCC between January 2000 and May 2007 were enrolled in the study. Before TACE was carried out, MELD, MELD-Na, Child-Pugh score, Okuda stage, CLIP score, JIS score, BCLC stage, and UICC stage were checked. After one month, δMELD and δMELD-Na were calculated. Results. Mean MELD/MELD-Na/δMELD/δMELD-Na scores were 7.5±3.7, 8.0±4.7, -0.2±3.5 and 0.04±4.5, respectively. MELD (p=0.009) and MELD-Na (p=0.017) significantly correlated with survival, but δMELD and δMELD-Na did not (p >0.05). The Child-Pugh score and other staging systems correlated significantly with survival (p <0.05). The AUROC values for 3, 12, and 36 months' survival were 0.633, 0.545, and 0.615 for MELD; 0.655, 0.555, and 0.612 for MELD-Na; 0.639, 0.616, and 0.691 for Child-Pugh score; 0.714, 0.662, and 0.717 for the Okuda score; 0.837, 0.86, and 0.792 for the CLIP score; 0.859, 0.814, and 0.808 for the JIS score; 0.846, 0.833, and 0.749 for BCLC stage; and 0.878, 0.812, and 0.735 for UICC stage, respectively. Conclusions. MELD and MELD-Na showed good correlations with survival, especially for patients with early-stage disease. However, these were not superior to those of other staging systems or Child-Pugh score. These parameters should only be used as supportive data.

Original languageEnglish
Pages (from-to)346-357
Number of pages12
JournalScandinavian Journal of Gastroenterology
Volume44
Issue number3
DOIs
Publication statusPublished - 2009 Mar 1

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End Stage Liver Disease
Hepatocellular Carcinoma
Survival

Keywords

  • HCC
  • MELD
  • Survival rate
  • TACE

ASJC Scopus subject areas

  • Gastroenterology

Cite this

@article{98c52891f0534bda80819dd423f7200f,
title = "Value of the model for end-stage liver disease for predicting survival in hepatocellular carcinoma patients treated with transarterial chemoembolization",
abstract = "Objective. The aim of this study was to evaluate the prognostic value of the model for end-stage liver disease (MELD) and its modified forms, and to compare these scoring systems with other staging systems for hepatocellular carcinoma (HCC) patients treated with transarterial chemoembolization (TACE). Material and methods. A total of 325 patients who underwent TACE for the initial treatment of HCC between January 2000 and May 2007 were enrolled in the study. Before TACE was carried out, MELD, MELD-Na, Child-Pugh score, Okuda stage, CLIP score, JIS score, BCLC stage, and UICC stage were checked. After one month, δMELD and δMELD-Na were calculated. Results. Mean MELD/MELD-Na/δMELD/δMELD-Na scores were 7.5±3.7, 8.0±4.7, -0.2±3.5 and 0.04±4.5, respectively. MELD (p=0.009) and MELD-Na (p=0.017) significantly correlated with survival, but δMELD and δMELD-Na did not (p >0.05). The Child-Pugh score and other staging systems correlated significantly with survival (p <0.05). The AUROC values for 3, 12, and 36 months' survival were 0.633, 0.545, and 0.615 for MELD; 0.655, 0.555, and 0.612 for MELD-Na; 0.639, 0.616, and 0.691 for Child-Pugh score; 0.714, 0.662, and 0.717 for the Okuda score; 0.837, 0.86, and 0.792 for the CLIP score; 0.859, 0.814, and 0.808 for the JIS score; 0.846, 0.833, and 0.749 for BCLC stage; and 0.878, 0.812, and 0.735 for UICC stage, respectively. Conclusions. MELD and MELD-Na showed good correlations with survival, especially for patients with early-stage disease. However, these were not superior to those of other staging systems or Child-Pugh score. These parameters should only be used as supportive data.",
keywords = "HCC, MELD, Survival rate, TACE",
author = "Kim, {Jeong Han} and Kim, {Ji Hoon} and Choi, {Jong Hwan} and Kim, {Chung Ho} and Jung, {Young Kul} and Yim, {Hyung Joon} and Yeon, {Jong Eun} and Park, {Jong Jae} and Kim, {Jae Seon} and Young-Tae Bak and Byun, {Kwan Soo}",
year = "2009",
month = "3",
day = "1",
doi = "10.1080/00365520802530838",
language = "English",
volume = "44",
pages = "346--357",
journal = "Scandinavian Journal of Gastroenterology",
issn = "0036-5521",
publisher = "Informa Healthcare",
number = "3",

}

TY - JOUR

T1 - Value of the model for end-stage liver disease for predicting survival in hepatocellular carcinoma patients treated with transarterial chemoembolization

AU - Kim, Jeong Han

AU - Kim, Ji Hoon

AU - Choi, Jong Hwan

AU - Kim, Chung Ho

AU - Jung, Young Kul

AU - Yim, Hyung Joon

AU - Yeon, Jong Eun

AU - Park, Jong Jae

AU - Kim, Jae Seon

AU - Bak, Young-Tae

AU - Byun, Kwan Soo

PY - 2009/3/1

Y1 - 2009/3/1

N2 - Objective. The aim of this study was to evaluate the prognostic value of the model for end-stage liver disease (MELD) and its modified forms, and to compare these scoring systems with other staging systems for hepatocellular carcinoma (HCC) patients treated with transarterial chemoembolization (TACE). Material and methods. A total of 325 patients who underwent TACE for the initial treatment of HCC between January 2000 and May 2007 were enrolled in the study. Before TACE was carried out, MELD, MELD-Na, Child-Pugh score, Okuda stage, CLIP score, JIS score, BCLC stage, and UICC stage were checked. After one month, δMELD and δMELD-Na were calculated. Results. Mean MELD/MELD-Na/δMELD/δMELD-Na scores were 7.5±3.7, 8.0±4.7, -0.2±3.5 and 0.04±4.5, respectively. MELD (p=0.009) and MELD-Na (p=0.017) significantly correlated with survival, but δMELD and δMELD-Na did not (p >0.05). The Child-Pugh score and other staging systems correlated significantly with survival (p <0.05). The AUROC values for 3, 12, and 36 months' survival were 0.633, 0.545, and 0.615 for MELD; 0.655, 0.555, and 0.612 for MELD-Na; 0.639, 0.616, and 0.691 for Child-Pugh score; 0.714, 0.662, and 0.717 for the Okuda score; 0.837, 0.86, and 0.792 for the CLIP score; 0.859, 0.814, and 0.808 for the JIS score; 0.846, 0.833, and 0.749 for BCLC stage; and 0.878, 0.812, and 0.735 for UICC stage, respectively. Conclusions. MELD and MELD-Na showed good correlations with survival, especially for patients with early-stage disease. However, these were not superior to those of other staging systems or Child-Pugh score. These parameters should only be used as supportive data.

AB - Objective. The aim of this study was to evaluate the prognostic value of the model for end-stage liver disease (MELD) and its modified forms, and to compare these scoring systems with other staging systems for hepatocellular carcinoma (HCC) patients treated with transarterial chemoembolization (TACE). Material and methods. A total of 325 patients who underwent TACE for the initial treatment of HCC between January 2000 and May 2007 were enrolled in the study. Before TACE was carried out, MELD, MELD-Na, Child-Pugh score, Okuda stage, CLIP score, JIS score, BCLC stage, and UICC stage were checked. After one month, δMELD and δMELD-Na were calculated. Results. Mean MELD/MELD-Na/δMELD/δMELD-Na scores were 7.5±3.7, 8.0±4.7, -0.2±3.5 and 0.04±4.5, respectively. MELD (p=0.009) and MELD-Na (p=0.017) significantly correlated with survival, but δMELD and δMELD-Na did not (p >0.05). The Child-Pugh score and other staging systems correlated significantly with survival (p <0.05). The AUROC values for 3, 12, and 36 months' survival were 0.633, 0.545, and 0.615 for MELD; 0.655, 0.555, and 0.612 for MELD-Na; 0.639, 0.616, and 0.691 for Child-Pugh score; 0.714, 0.662, and 0.717 for the Okuda score; 0.837, 0.86, and 0.792 for the CLIP score; 0.859, 0.814, and 0.808 for the JIS score; 0.846, 0.833, and 0.749 for BCLC stage; and 0.878, 0.812, and 0.735 for UICC stage, respectively. Conclusions. MELD and MELD-Na showed good correlations with survival, especially for patients with early-stage disease. However, these were not superior to those of other staging systems or Child-Pugh score. These parameters should only be used as supportive data.

KW - HCC

KW - MELD

KW - Survival rate

KW - TACE

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U2 - 10.1080/00365520802530838

DO - 10.1080/00365520802530838

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JO - Scandinavian Journal of Gastroenterology

JF - Scandinavian Journal of Gastroenterology

SN - 0036-5521

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