Back to Journals » Cancer Management and Research » Volume 12

A Novel Pathological Scoring System for Hepatic Cirrhosis with Hepatocellular Carcinoma

Authors Dong W, Yu H, Zhu YY, Xian ZH, Chen J, Wang H, Shi CC, Jin GZ, Dong H, Cong WM

Received 16 July 2019

Accepted for publication 17 May 2020

Published 8 July 2020 Volume 2020:12 Pages 5537—5547

DOI https://doi.org/10.2147/CMAR.S223417

Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 2

Editor who approved publication: Professor Lu-Zhe Sun


Wei Dong,1,2,* Hua Yu,1,2,* Yu-Yao Zhu,1,2,* Zhi-Hong Xian,1,2 Jia Chen,1,2 Hao Wang,3 Chun-Chao Shi,4 Guang-Zhi Jin,5 Hui Dong,1,2 Wen-Ming Cong1,2

1Department of Pathology, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai 200438, People’s Republic of China; 2Key Laboratory of Signaling Regulation and Targeting Therapy of Liver Cancer, Second Military Medical University, The Ministry of Education, Shanghai 200438, People’s Republic of China; 3Department of Hepatobiliary Diseases, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai 200438, People’s Republic of China; 4Second Department of Hepatic Surgery, Eastern Hepatobiliary Hospital, Second Military Medical University, Shanghai 200438, People’s Republic of China; 5Department of Oncology, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200050, People’s Republic of China

*These authors contributed equally to this work

Correspondence: Hui Dong
Department of Pathology, Eastern Hepatobiliary Surgery Hospital, Shanghai 200438, People’s Republic of China
Email 13917078308@126.com
Wen-Ming Cong
Department of Pathology, Eastern Hepatobiliary Surgery Hospital, Shanghai 200438, People’s Republic of China
Email wmcong@smmu.edu.cn

Purpose: This study aimed to propose an effective quantitative pathological scoring system and to establish nomogram to assess the stage of cirrhosis and predict postoperative survival of hepatocellular carcinoma (HCC) with cirrhosis patients after hepatectomy.
Methods: The scoring system was based on a retrospective study on 163 patients who underwent partial hepatectomy for HCC with cirrhosis. The clinicopathological and follow-up data of 163 HCC with cirrhosis patients who underwent hepatectomy in our hospital from 2010 to 2014 were retrospectively reviewed. A scoring system was established based on the total value of independent predictive factors of cirrhosis. The results were validated using 97 patients operated on from 2011 to 2015 at the same institution. Nomogram was then formulated using a multivariate Cox proportional hazards model to analyze.
Results: The scoring system was ultimately composed of 4 independent predictive factors and was divided into 3 levels. The new cirrhosis system score strongly correlated with Child–Pugh score (r=0.8058, P< 0.0001) 3 months after surgery; higher cirrhosis system scores predicted poorer liver function and stronger liver damage 3 months after surgery. Then, a four-factor nomogram for survival prediction was established. The concordance indices were 0.79 for the survival-prediction nomogram. The calibration curves showed good agreement between predictions by the nomogram and actual survival outcomes.
Conclusion: This new scoring system of cirrhosis can help us predict the liver function and liver injury 3 months after surgery, and the nomogram enabled accurate predictions of risk of overall survival in patients of HCC with cirrhosis after hepatectomy.

Keywords: cirrhosis, hepatocellular carcinoma, HCC, pathology, scoring system, nomogram

Creative Commons License This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.

Download Article [PDF]  View Full Text [HTML][Machine readable]