Validation of the HCC-MELD for dropout probability in patients with small hepatocellular carcinoma undergoing locoregional therapy.
BACKGROUND
The model for end-stage liver disease (MELD) is used in prioritizing cirrhotic patients awaiting liver transplantation. Patients with small hepatocellular carcinoma (HCC) are eligible candidates. An HCC-MELD equation was recently proposed to predict the dropout rate of HCC patients on the waiting list. This study aimed to validate the accuracy of this equation.


METHODS
We investigated 390 patients with small HCC who were candidates for liver transplantation and underwent locoregional therapy.


RESULTS
The estimated probability of dropout according to the equation was 8.2% for T1 stage and 13.5% for T2 stage HCC (p < 0.0001). The actual disease progression rate at three months was 2.1% for T1 and 3.0% for T2 stage HCC. At six months, the progression rate was 5.3% for T1 stage and 6.8% for T2 stage. The area under receiver operating characteristic curve of the HCC-MELD equation was 0.81 at three months and 0.80 at six months. Patients undergoing radiofrequency ablation (RFA) had significantly lower dropout rates compared with other treatment groups according to the equation (p = 0.0007). The actual tumor progression rate was also the lowest for the RFA group at both three and six months.


CONCLUSIONS
The HCC-MELD equation is a feasible predictive model for patients with small HCC undergoing locoregional therapy.
Huo
Teh-Ia
TI
Department of Medicine, Taipet Veterans General Hospital, Taipei, Taiwan. tihuo@vghtpe.gov.tw
Huang
Yi-Hsiang
YH
Su
Chien-Wei
CW
Lin
Han-Chieh
HC
Chiang
Jen-Huei
JH
Chiou
Yi-You
YY
Huo
Samantha C
SC
Lee
Pui-Ching
PC
Lee
Shou-Dong
SD
D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000150:complications* / Q000601:surgery; D017115:Catheter Ablation; D016461:Chemoembolization, Therapeutic; D003661:Decision Support Techniques; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D015276:Health Care Rationing; D006801:Humans; D008113:Liver Neoplasms / Q000150:complications* / Q000601:surgery; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D008954:Models, Biological; D009367:Neoplasm Staging; D010352:Patient Dropouts; D018579:Patient Selection; D011336:Probability; D011446:Prospective Studies