Clinical validity of Metroticket calculator in transplant patients undergoing prior chemoembolization for hepatocellular carcinoma
- Authors
- Kim, Hyung-Don; Song, Gi-Won; Shim, Ju Hyun; Han, Seungbong; An, Jihyun; Moon, Deok-Bog; Kim, Kang Mo; Lim, Young-Suk; Ko, Gi-Young; Hwang, Shin; Lee, Han Chu; Yu, Eunsil; Sung, Kyu-Bo; Lee, Sung-Gyu
- Issue Date
- Mar-2017
- Publisher
- SPRINGER
- Keywords
- Metroticket calculator; Hepatocellular carcinoma; Transarterial chemoembolization; Liver transplantation; Validation
- Citation
- HEPATOLOGY INTERNATIONAL, v.11, no.2, pp.209 - 219
- Journal Title
- HEPATOLOGY INTERNATIONAL
- Volume
- 11
- Number
- 2
- Start Page
- 209
- End Page
- 219
- URI
- https://scholarworks.bwise.kr/gachon/handle/2020.sw.gachon/6381
- DOI
- 10.1007/s12072-017-9785-2
- ISSN
- 1936-0533
- Abstract
- To test the predictive performance of the Metroticket calculator for survival after liver transplantation (LT) of patients with hepatocellular carcinoma (HCC) undergoing prior transarterial chemoembolization (TACE). A total of 142 patients treated with TACE and subsequent LT who had arterial enhancing HCC(s) were entered into this analysis. Tumor parameters measured by the enhancement radiological method pre-LT or by pathology post-LT were incorporated into the Metroticket analysis. The calculator was validated in terms of calibration and discrimination capacity. Mean 3- and 5-year survival rates predicted in the radiological model for all 142 patients were 76.4 and 70.1 %, respectively, lying comfortably within the 95 % confidence interval (CI) of the observed survival rate estimates (72.8-86.2 and 68.6-83.2 %, respectively). In the pathological model incorporating microvascular invasion, the mean anticipated survival rate at 5 years of 120 patients with viable nodules on explants was 69.5 %, also lying inside the 95 % CI of the actuarial rates (67.9-83.5 %). The c-indices as measures of discriminatory power were 0.61 and 0.62, respectively, for the 3- and 5-year predictions in the radiological model, and 0.72 for the 5-year prediction in the pathological model. The corresponding findings were similar for subgroups with hepatitis B virus infection and undergoing living-donor LT. The Metroticket calculation based on explant data accurately predicts post-LT survival of HCC patients with prior TACE. Imaging estimate-based predictions before LT appear to provide poorer discrimination than calibration.
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