Multicenter Validation Study of a Prognostic Index for Portal Vein Tumor Thrombosis in Hepatocellular Carcinoma.
- Author:
Jeong Il YU
1
;
Sang Min YOON
;
Hee Chul PARK
;
Jong Hoon KIM
;
Tae Hyun KIM
;
Joong Won PARK
;
Jinsil SEONG
;
Ik Jae LEE
;
Hong Seok JANG
;
Chul Seung KAY
;
Chul Yong KIM
;
Eui Kyu CHIE
;
Jin Hee KIM
;
Mi Sook KIM
;
Young Min CHOI
Author Information
- Publication Type:Multicenter Study ; Original Article
- Keywords: Hepatocellular carcinoma; Portal vein; Radiotherapy; Multicenter study; Validation
- MeSH: Area Under Curve; Asian Continental Ancestry Group; Carcinoma, Hepatocellular*; Humans; Liver Neoplasms; Portal Vein*; Radiation Oncology; Radiotherapy; Retrospective Studies; ROC Curve; Thrombosis*
- From:Cancer Research and Treatment 2014;46(4):348-357
- CountryRepublic of Korea
- Language:English
- Abstract: PURPOSE: We previously reported on a staging system and prognostic index (PITH) for portal vein tumor thrombosis (PVTT) in hepatocellular carcinoma (HCC) patients treated with radiotherapy (RT) at a single institution. The aim of this study is to validate the PITH staging system using data from patients at other institutions and to compare it with other published staging systems. MATERIALS AND METHODS: A total of 994 HCC patients with PVTT who were treated with RT between 1998 and 2011 by the Korean Radiation Oncology Group were analyzed retrospectively. All patients were staged using the Cancer of the Liver Italian Program (CLIP), Japanese Integrated Staging (JIS), Okuda, and PITH staging systems, and survival data were analyzed. The likelihood ratio, Akaike information criteria (AIC), time-dependent receiver operating characteristics, and prediction error curve analysis were used to determine discriminatory ability for comparison of staging systems. RESULTS: The median survival was 9.2 months. Compared with the other staging systems, the PITH score gave the highest values for likelihood ratio and lowest AIC values, demonstrating that PITH may be a better prognostic model. Although the values were not significant and differences were not exceptional, the PITH score showed slightly better performance with respect to time-dependent area under curve and integrated Brier score of prediction error curve. CONCLUSION: The PITH staging system was validated in this multicenter retrospective study and showed better stratification ability in HCC patients with PVTT than other systems.
