Validation of a Modified Child-Turcotte-Pugh Classification System Utilizing Insulin-Like Growth Factor-1 for Patients with Hepatocellular Carcinoma in an HBV Endemic AreaReport as inadecuate




Validation of a Modified Child-Turcotte-Pugh Classification System Utilizing Insulin-Like Growth Factor-1 for Patients with Hepatocellular Carcinoma in an HBV Endemic Area - Download this document for free, or read online. Document in PDF available to download.

Background

Recently, a modified insulin-like growth factor-1 IGF–Child-Turcotte-Pugh CTP classification was proposed to improve the original CTP classification. This study aimed to validate the new IGF-CTP classification system as a prognostic maker for patients with hepatocellular carcinoma HCC in a hepatitis B virus endemic area.

Methods

We conducted a post-hoc analysis of a prospective cohort study. We used Harrell’s C-index and U-statistics to compare the prognostic performance of both IGF-CTP and CTP classifications for overall survival. We evaluated the relationship between HCC stage and the four components of the IGF-CTP classification serum levels of IGF-1, albumin, and total bilirubin and prothrombin time PT using nonparametric trend analysis.

Results

We included a total of 393 patients in this study. In all, 55 patients died during the median follow-up of 59.1 months. There was a difference between IGF-CTP class and CTP class in 14% of patients. Overall, the IGF-CTP classification system had a higher prognostic value C-index = 0.604, 95% confidence interval CI = 0.539–0.668 than the CTP system C-index = 0.558, 95% CI = 0.501–0.614, but the difference was not statistically significant P = .07 by U-statistics. A lower serum level of IGF-1 was related to a more advanced cancer stage P < .01. The remaining components of the IGF-CTP classification were not significantly related to tumor stage P = .11 for total bilirubin; P = .33 for albumin; and P = .39 for PT.

Conclusions

The IGF-CTP classification was slightly better than the original CTP classification for predicting survival of patients with HCC in a chronic hepatitis B endemic area. This is most likely due to the fact that serum IGF-1 levels reflect underlying HCC status.



Author: Dong Hyeon Lee, Jeong-Hoon Lee , Yong Jin Jung , Jungsoo Gim, Won Kim, Byeong Gwan Kim, Kook Lae Lee, Yuri Cho, Jeong-Ju Yoo, Min

Source: http://plos.srce.hr/



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