Korean Version of a Model to Estimate Survival in Ambulatory Patients with Hepatocellular Carcinoma (K-MESIAH).
OBJECTIVE
A model to estimate survival in ambulatory hepatocellular carcinoma patients (MESIAH) is useful for estimating patient prognosis but needs improvement for Korean patients, most of whom have a hepatitis B virus. We aimed to modify the MESIAH for better prognostication through enhancing calibration for Korean patient population (K-MESIAH).


METHODS
Utilizing a cohort of 1,969 hepatocellular carcinoma (HCC) patients from the National Cancer Center of Korea between 2004 and 2009, a survival prediction model was developed using the Cox proportional hazards model. The model's performance was evaluated using C-statistical and χ2-statistical analyses. External validation was performed using an independent cohort of 328 patients from the Seoul National University Bundang Hospital.


RESULTS
To develop the K-MESIAH, etiology was added to the original risk factors (age, Model for Endstage Liver Disease, albumin, size of the largest nodule, number of tumor nodules, vascular invasion, metastasis, and alpha fetoprotein) in the MESIAH. From the internal validation study, the C-statistics and χ2-statistics for one-, three-, and five-years of survival were 0.83 (95% Confidence Interval: 0.82-0.85), 49.07; 0.81 (95% Confidence Interval: 0.79-0.82), 28.95; and 0.80 (95% Confidence Interval: 0.79-0.81), 20.93, respectively. The K-MESIAH also showed a high prediction ability for the external validation cohort.


CONCLUSIONS
A survival prediction model for Korean HCC patients was developed and validated to have a high level of performance. This K-MESIAH may be more useful in clinical practice and personalized care in a hepatitis B virus endemic area.
Department of Cancer Control and Policy, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Republic of Korea.
Byung-Ho
BH
Nam
Center for Liver Cancer, National Cancer Center, Goyang, Republic of Korea.
Joong-Won
JW
Park
Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University, College of Medicine, Seongnam, Republic of Korea.
Sook-Hyang
SH
Jeong
Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University, College of Medicine, Seongnam, Republic of Korea.
Sang Soo
SS
Lee
Biometric Research Branch, National Cancer Center, Goyang, Republic of Korea.
Ami
A
Yu
Center for Liver Cancer, National Cancer Center, Goyang, Republic of Korea.
Bo Hyun
BH
Kim
Division of Gastroenterology and Hepatology Stanford University, Stanford, California, United States of America.
W Ray
WR
Kim
D000553:Ambulatory Care / Q000706:statistics & numerical data*; D006528:Carcinoma, Hepatocellular / Q000401:mortality*; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D011379:Prognosis; D011446:Prospective Studies; D056910:Republic of Korea; D012307:Risk Factors; D015996:Survival Rate