Detailed Abstract
[Liver Oral Presentation 1 - Liver (Liver Disease/Surgery)]
[LV OP 1-4] DEVELOPMENT AND VALIDATION OF A LABORATORY RISK SCORE (APASL SCORE) TO PREDICT LONG-TERM SURVIVAL AFTER HEPATECTOMY FOR HEPATOCELLULAR CARCINOMA: A MULTICENTER ANALYSIS
Bai-Dong WANG 1, Mng-Da HE 1, Jia-Hao XU 2, Lei CAI 3, Ying-Jian LIANG 4, Hong-Wei GUO 5, Kong-Ying LIN 6, Zi-Qaing LI 7, Qi-Xuab ZHENG 8, Ya-Hao ZHOU 9, Ting-Tao CHEN 10, Hong WANG 11, Yi-Fan LI 12, Tian YANG 2
1 Naval Medical University, Basic Medical College, China, 2 Department of Hepatobiliary Surgery, Eastern Hepatobiliary Surgery Hospital, China, 3 Chongqing General Hospital, Institute of Hepatopancreatobiliary Surgery, China, 4 Department of Hepatobiliary Surgery, The First Affiliated Hospital of Harbin Medical University, China, 5 The 2nd Department of General Surgery, The Second People’s Hospital of Changzhi, China, 6 Department of Hepatobiliary Surgery, Mengchao Hepatobiliary Hospital, China, 7 Department of Liver Transplantation And Hepatic Surgery, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, China, 8 Department of Hepatobiliary Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University, China, 9 Department of Hepatobiliary Surgery, Pu’er People’s Hospital, China, 10 Department of General Surgery, Ziyang First People’s Hospital, China, 11 Department of General Surgery, Liuyang People’s Hospital, China, 12 Department of Hepatobiliary Surgery, Affiliated Hospital of Nantong University, China
Background : To develop and validate a novel, purely laboratory-based risk score (APASL score) for predicting long-term survival outcomes after hepatectomy for hepatocellular carcinoma (HCC). Accurate prediction of long-term survival after hepatectomy for HCC is crucial for surgical decision-making and patient counseling. Existing staging systems that incorporate tumor characteristics may not be available preoperatively. A risk score based solely on preoperative laboratory parameters could provide valuable prognostic information.
Methods : From a multicenter database, patients who underwent hepatectomy for initially-diagnosed HCC were included. The APASL score was developed to predict long-term overall survival using five preoperative laboratory variables: alpha-fetoprotein (AFP), platelet count (PLT), albumin (ALB), aspartate aminotransferase (AST), and bilirubin (BIL). The score was validated in an independent cohort.
Results : The development cohort included 1,286 patients from 9 hospitals, and the validation cohort included 469 patients from another 2 hospitals. The APASL score demonstrated excellent discriminatory ability, with c-indices of 0.812 and 0.783 in the development and validation cohorts, respectively. The score outperformed traditional staging systems, including TNM, BCLC, CLIP, and Milan criteria. Higher APASL scores were associated with significantly worse overall survival (P<0.001). The higher APASL scores remained an independent prognostic factor in multivariate analysis (hazard ratio: 2.154, 95% confidence interval: 1.782-2.609, p<0.001).
Conclusions : The APASL score is a simple, accurate, and purely laboratory-based tool for predicting long-term survival after hepatectomy for HCC. It can facilitate preoperative risk stratification and patient counseling, without the need for tumor characteristics that may only be available postoperatively.
Methods : From a multicenter database, patients who underwent hepatectomy for initially-diagnosed HCC were included. The APASL score was developed to predict long-term overall survival using five preoperative laboratory variables: alpha-fetoprotein (AFP), platelet count (PLT), albumin (ALB), aspartate aminotransferase (AST), and bilirubin (BIL). The score was validated in an independent cohort.
Results : The development cohort included 1,286 patients from 9 hospitals, and the validation cohort included 469 patients from another 2 hospitals. The APASL score demonstrated excellent discriminatory ability, with c-indices of 0.812 and 0.783 in the development and validation cohorts, respectively. The score outperformed traditional staging systems, including TNM, BCLC, CLIP, and Milan criteria. Higher APASL scores were associated with significantly worse overall survival (P<0.001). The higher APASL scores remained an independent prognostic factor in multivariate analysis (hazard ratio: 2.154, 95% confidence interval: 1.782-2.609, p<0.001).
Conclusions : The APASL score is a simple, accurate, and purely laboratory-based tool for predicting long-term survival after hepatectomy for HCC. It can facilitate preoperative risk stratification and patient counseling, without the need for tumor characteristics that may only be available postoperatively.
SESSION
Liver Oral Presentation 1
Room 1 3/27/2025 3:30 PM - 4:30 PM