title: NIACE score for hepatocellular carcinoma patients treated by surgery or transarterial chemoembolization.
abstract: OBJECTIVE
  Hepatocellular carcinoma (HCC) prognostic scores could be useful in addition to the Barcelona Clinic Liver Cancer (BCLC) system to clarify patient prognosis and guide treatment decision. The NIACE (tumor Nodularity, Infiltrative nature of the tumor, serum Alpha-fetoprotein level, Child-Pugh stage, ECOG performance status) score distinguishes different prognosis groups among BCLC A, B, and C HCC patients. Our aims are to evaluate the NIACE score and its additive value in two HCC cohorts treated either by surgery or by chemoembolization, and then according to the BCLC recommendations.
  
  
  METHODS
  This was a retrospective multicenter study with two BCLC A, B, and C HCC cohorts treated either by surgery (n=207) or by chemoembolization (n=168) carried out between 2008 and 2013. We studied survival time according to the baseline NIACE score and compared it with the Cancer of the Liver Italian Program score and the BCLC system.
  
  
  RESULTS
  The NIACE score differentiates between subgroups of patients with different prognosis within each BCLC class. Among BCLC A patients treated by surgery and BCLC B patients treated by chemoembolization, the NIACE score differentiates between two subgroups with a significant difference in survival time: 68 (55-81) months versus 35 (21-56) months (P=0.0004) and 20 (17-24) months versus 13 (7-17) months (P=0.0008), respectively. Among those subgroups, the NIACE score has a significantly better prognostic value than the BCLC system or the Cancer of the Liver Italian Program score.
  
  
  CONCLUSIONS
  In this study, among HCC patients treated according to the BCLC recommendations, the NIACE score predicts more accurately than any other system the survival time.
authors.affiliation: aDepartment of Hepato-Gastroenterology bDepartment of Hepatobiliary Surgery cDepartment of Radiology, Hôpital Saint-Joseph dAlphaBio Laboratory eDepartment of Hepato-Gastroenterology and Digestive Oncology, Institut Paoli-Calmette fDepartment of Hepatobiliary Surgery, Centre Hospitalo-Universitaire Timone, Marseille gDepartment of Hepato-Gastroenterology, Centre Hospitalo-Universitaire de Nancy hINSERM U954, Université de Lorraine, CHU de Nancy, Vandoeuvre les Nancy, France.
authors.forename: Xavier
authors.initials: X
authors.lastname: Adhoute
authors.forename: Guillaume
authors.initials: G
authors.lastname: Pénaranda
authors.forename: Jean Luc
authors.initials: JL
authors.lastname: Raoul
authors.forename: Emilie
authors.initials: E
authors.lastname: Bollon
authors.forename: Bernard
authors.initials: B
authors.lastname: Pol
authors.forename: Yves P
authors.initials: YP
authors.lastname: Letreut
authors.forename: Hervé
authors.initials: H
authors.lastname: Perrier
authors.forename: Olivier
authors.initials: O
authors.lastname: Bayle
authors.forename: Olivier
authors.initials: O
authors.lastname: Monnet
authors.forename: Patrick
authors.initials: P
authors.lastname: Beaurain
authors.forename: Cyril
authors.initials: C
authors.lastname: Muller
authors.forename: Jean
authors.initials: J
authors.lastname: Hardwigsen
authors.forename: Gaëlle
authors.initials: G
authors.lastname: Lefolgoc
authors.forename: Paul
authors.initials: P
authors.lastname: Castellani
authors.forename: Jean P
authors.initials: JP
authors.lastname: Bronowicki
authors.forename: Marc
authors.initials: M
authors.lastname: Bourlière
mesh_terms: D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000097:blood / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D016461:Chemoembolization, Therapeutic / Q000009:adverse effects / Q000401:mortality; D003661:Decision Support Techniques; D005260:Female; D005602:France; D006304:Health Status; D006498:Hepatectomy / Q000009:adverse effects / Q000401:mortality; D006801:Humans; D053208:Kaplan-Meier Estimate; D008113:Liver Neoplasms / Q000097:blood / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging / Q000379:methods*; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D015203:Reproducibility of Results; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D000509:alpha-Fetoproteins / Q000032:analysis
chemical_list: C097353:AFP protein, human; D000509:alpha-Fetoproteins