Please use this identifier to cite or link to this item: http://doi.org/10.25358/openscience-289
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dc.contributor.authorMähringer-Kunz, Aline-
dc.contributor.authorWeinmann, Arndt-
dc.contributor.authorSchmidtmann, Irene-
dc.contributor.authorKoch, Sandra-
dc.contributor.authorSchotten, Sebastian-
dc.contributor.authorPinto dos Santos, Daniel-
dc.contributor.authorPitton, Michael B.-
dc.contributor.authorDüber, Christoph-
dc.contributor.authorGalle, Peter R.-
dc.contributor.authorKlöckner, Roman-
dc.date.accessioned2018-10-17T13:07:38Z-
dc.date.available2018-10-17T15:07:38Z-
dc.date.issued2018-
dc.identifier.urihttps://openscience.ub.uni-mainz.de/handle/20.500.12030/291-
dc.description.abstractBackground Transarterial chemoembolisation is the standard of care for intermediate stage (BCLC B) hepatocellular carcinoma, but it is challenging to decide when to repeat or stop treatment. Here we performed the first external validation of the SNACOR (tumour Size and Number, baseline Alpha-fetoprotein, Child-Pugh and Objective radiological Response) risk prediction model. Methods A total of 1030 patients with hepatocellular carcinoma underwent transarterial chemoembolisation at our tertiary referral centre from January 2000 to December 2016. We determined the following variables that were needed to calculate the SNACOR at baseline: tumour size and number, alpha-fetoprotein level, Child-Pugh class, and objective radiological response after the first transarterial chemoembolisation. Overall survival, time-dependent area under receiver-operating characteristic curves, Harrell’s C-index, and the integrated Brier score were calculated to assess predictive ability. Finally, multivariate analysis was performed to identify independent predictors of survival. Results The study included 268 patients. Low, intermediate, and high SNACOR scores predicted a median survival of 31.5, 19.9, and 9.2 months, respectively. The areas under the receiver-operating characteristic curve for overall survival were 0.641, 0.633, and 0.609 at 1, 3, and 6 years, respectively. Harrell’s C-index was 0.59, and the integrated Brier Score was 0.175. Independent predictors of survival included tumour size (P < 0.001), baseline alpha-fetoprotein level (P < 0.001) and Child-Pugh class (P < 0.004). Objective radiological response (P = 0.821) and tumour number (P = 0.127) were not additional independent predictors of survival. Conclusions The SNACOR risk prediction model can be used to identify patients with a dismal prognosis after the first transarterial chemoembolisation who are unlikely to benefit from further transarterial chemoembolisation. However, Harrell’s C-index showed only moderate performance. Accordingly, this risk prediction model can only serve as one of several components used to make the decision about whether to repeat treatment.en_GB
dc.description.sponsorshipDFG, Open Access-Publizieren Universität Mainz / Universitätsmedizin-
dc.language.isoeng-
dc.rightsCC BYde_DE
dc.rights.urihttps://creativecommons.org/licenses/by/4.0/-
dc.subject.ddc610 Medizinde_DE
dc.subject.ddc610 Medical sciencesen_GB
dc.titleValidation of the SNACOR clinical scoring system after transarterial chemoembolisation in patients with hepatocellular carcinomaen_GB
dc.typeZeitschriftenaufsatzde_DE
dc.identifier.urnurn:nbn:de:hebis:77-publ-585069-
dc.identifier.doihttp://doi.org/10.25358/openscience-289-
jgu.type.dinitypearticle-
jgu.type.versionPublished versionen_GB
jgu.type.resourceText-
jgu.organisation.departmentFB 04 Medizin-
jgu.organisation.number2700-
jgu.organisation.nameJohannes Gutenberg-Universität Mainz-
jgu.rights.accessrightsopenAccess-
jgu.journal.titleBMC cancer-
jgu.journal.volume18-
jgu.pages.alternativeArt. 489-
jgu.publisher.year2018-
jgu.publisher.nameBioMed Central-
jgu.publisher.placeLondon-
jgu.publisher.urihttp://dx.doi.org/10.1186/s12885-018-4407-5-
jgu.publisher.issn1471-2407-
jgu.organisation.placeMainz-
jgu.subject.ddccode610-
opus.date.accessioned2018-10-17T13:07:38Z-
opus.date.modified2018-10-19T08:39:56Z-
opus.date.available2018-10-17T15:07:38-
opus.subject.dfgcode00-000-
opus.organisation.stringFB 04: Medizin: I. Medizinische Klinik und Poliklinikde_DE
opus.organisation.stringFB 04: Medizin: Institut für Med. Biometrie, Epidemologie und Informatikde_DE
opus.organisation.stringFB 04: Medizin: Klinik und Poliklinik für Diagnostische und Interventionelle Radiologiede_DE
opus.identifier.opusid58506-
opus.institute.number0425-
opus.institute.number0424-
opus.institute.number0419-
opus.metadataonlyfalse-
opus.type.contenttypeKeinede_DE
opus.type.contenttypeNoneen_GB
opus.affiliatedMähringer-Kunz, Aline-
opus.affiliatedWeinmann, Arndt-
opus.affiliatedSchmidtmann, Irene-
opus.affiliatedSchotten, Sebastian-
opus.affiliatedPitton, Michael B.-
opus.affiliatedDüber, Christoph-
opus.affiliatedGalle, Peter R.-
opus.affiliatedKlöckner, Roman-
jgu.publisher.doi10.1186/s12885-018-4407-5
jgu.organisation.rorhttps://ror.org/023b0x485
Appears in collections:JGU-Publikationen

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