Survival Estimates after Stopping Sorafenib in Patients with Hepatocellular Carcinoma: NEXT Score Development and Validation.
- Author:
Hye Won LEE
1
;
Hyun Soo KIM
;
Seung Up KIM
;
Do Young KIM
;
Beom Kyung KIM
;
Jun Yong PARK
;
Sang Hoon AHN
;
Mi Young JEON
;
Ja Yoon HEO
;
Soo Young PARK
;
Yu Rim LEE
;
Sun Kyung JANG
;
Su Hyun LEE
;
Se Young JANG
;
Won Young TAK
;
Kwang Hyub HAN
Author Information
- Publication Type:Original Article
- Keywords: Hepatocellular carcinoma; Survival; Sorafenib; Prediction; Risk
- MeSH: Carcinoma, Hepatocellular*; Cohort Studies; Humans; Prognosis; ROC Curve; Sodium; Survival Rate
- From:Gut and Liver 2017;11(5):693-701
- CountryRepublic of Korea
- Language:English
- Abstract: 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.
