Survival estimates after stopping sorafenib in patients with hepatocellular carcinoma: NEXT score development and validation

Hye Won Lee, Hyun Soo Kim, Seung Up Kim, Do Young Kim, Beom Kyung Kim, Jun Yong Park, Sang Hoon Ahn, Mi Young Jeon, Ja Yoon Heo, Soo Young Park, Yu Rim Lee, Sun Kyung Jang, Su Hyun Lee, Se Young Jang, Won Young Tak, Kwang Hyub Han

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Abstract

Background/Aims: Limited information is available regarding patient survival after sorafenib discontinuation in patients with hepatocellular carcinoma (HCC). Thus, we developed and validated a novel survival prediction model. Methods: Clinical data from 409 patients with HCC who stopped taking sorafenib between September 2008 and February 2015 were reviewed. Results: In the training cohort, four factors were independent negative predictors of survival (p<0.05). Based on the β regression coefficient of each factor, we established the NEXT score (Survival after Stopping Nexavar Treatment), allocating 1 point each for an Eastern Cooperative Oncology Group score ≥2, Child-Pugh class B or C, serum sodium ≤135 mEq/L, and α-fetoprotein >400 ng/mL. Area under the receiver operating characteristic curve values to predict 1-, 3-, and 6-month survival rates were 0.805, 0.809, and 0.774, respectively, in the training cohort and 0.783, 0.728, and 0.673, respectively, in the validation cohort (n=137). When the training and validation cohorts were stratified into three risk groups (NEXT score 0 [low-risk] vs 1 to 2 [intermediate-risk] vs 3 to 4 [high-risk]), survival differed significantly between the groups (p<0.05, log-rank test). Conclusions: In patients with HCC, survival after stopping sorafenib is poor. However, risk estimates based on a new "NEXT score" may help predict survival and prognosis even in patients who discontinue sorafenib treatment.

Original languageEnglish
Pages (from-to)693-701
Number of pages9
JournalGut and liver
Volume11
Issue number5
DOIs
Publication statusPublished - 2017 Sep

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All Science Journal Classification (ASJC) codes

  • Hepatology
  • Gastroenterology

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