title: Prognostic model for hepatocellular carcinoma with time-dependent factors.
abstract: The purpose of this study was to build a prognostic model of hepatocellular carcinoma (HCC) using time-dependent covariates to re-evaluate the prognosis at any stage of the disease. The subjects were consecutive HCC patients who were treated at our institute between 1995 and 2007. We constructed time-fixed and time-dependent prognostic models with a training group (n=336) and compared the prognostic abilities between conventional Cancer of the Liver Italian Program (CLIP) scores, Japan Integrated Staging (JIS) scores, an Okuda classification, and our prognostic models in the testing group (n=227) with the c-index. The time-dependent prognostic model consisted of main tumor size, tumor number, portal vein invasion, distant metastasis, alpha-fetoprotein, des-gamma-carboxy prothrombin (DCP), bilirubin, and albumin and the weighted scores were set for each factor depending on the hazard ratio for the prognosis. The prognostic index was determined by summing the scores. The c-index values for the CLIP scores, JIS scores, Okuda classification, and our time-dependent model were 0.741, 0.727, 0.609, and 0.870, respectively. These results indicate that our time-dependent model can estimate the prognosis of HCC more precisely than traditional time-fixed models and can be used to re-predict the prognosis of HCC.
authors.affiliation: Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8558, Japan. kkuwaki-gi@umin.net
authors.forename: Kenji
authors.initials: K
authors.lastname: Kuwaki
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Nouso
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Kobayashi
authors.forename: Shinichiro
authors.initials: S
authors.lastname: Nakamura
authors.forename: Yoichi M
authors.initials: YM
authors.lastname: Ito
authors.forename: Shouta
authors.initials: S
authors.lastname: Iwadou
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Hagihara
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Yasunaka
authors.forename: Junichi
authors.initials: J
authors.lastname: Toshimori
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Miyatake
authors.forename: Kenji
authors.initials: K
authors.lastname: Miyoshi
authors.forename: Hideki
authors.initials: H
authors.lastname: Onishi
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Miyake
authors.forename: Bon
authors.initials: B
authors.lastname: Shoji
authors.forename: Akinobu
authors.initials: A
authors.lastname: Takaki
authors.forename: Hidenori
authors.initials: H
authors.lastname: Shiraha
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Iwasaki
authors.forename: Haruhiko
authors.initials: H
authors.lastname: Kobashi
authors.forename: Kazuhide
authors.initials: K
authors.lastname: Yamamoto
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000401:mortality* / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008113:Liver Neoplasms / Q000401:mortality* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D016016:Proportional Hazards Models; D016019:Survival Analysis; D013997:Time Factors; D055815:Young Adult