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

Research output: Contribution to journalArticle

2 Citations (Scopus)

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

Fingerprint

Hepatocellular Carcinoma
Survival
ROC Curve
sorafenib
Survival Rate
Therapeutics

All Science Journal Classification (ASJC) codes

  • Hepatology
  • Gastroenterology

Cite this

Lee, Hye Won ; Kim, Hyun Soo ; Kim, Seung Up ; Kim, Do Young ; Kim, Beom Kyung ; Park, Jun Yong ; Ahn, Sang Hoon ; Jeon, Mi Young ; Heo, Ja Yoon ; Park, Soo Young ; Lee, Yu Rim ; Jang, Sun Kyung ; Lee, Su Hyun ; Jang, Se Young ; Tak, Won Young ; Han, Kwang Hyub. / Survival estimates after stopping sorafenib in patients with hepatocellular carcinoma : NEXT score development and validation. In: Gut and liver. 2017 ; Vol. 11, No. 5. pp. 693-701.
@article{0ce0964226ae48be8b6e1caea57c59ff,
title = "Survival estimates after stopping sorafenib in patients with hepatocellular carcinoma: NEXT score development and validation",
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.",
author = "Lee, {Hye Won} and Kim, {Hyun Soo} and Kim, {Seung Up} and Kim, {Do Young} and Kim, {Beom Kyung} and Park, {Jun Yong} and Ahn, {Sang Hoon} and Jeon, {Mi Young} and Heo, {Ja Yoon} and Park, {Soo Young} and Lee, {Yu Rim} and Jang, {Sun Kyung} and Lee, {Su Hyun} and Jang, {Se Young} and Tak, {Won Young} and Han, {Kwang Hyub}",
year = "2017",
month = "9",
doi = "10.5009/gnl16391",
language = "English",
volume = "11",
pages = "693--701",
journal = "Gut and Liver",
issn = "1976-2283",
publisher = "Joe Bok Chung",
number = "5",

}

Survival estimates after stopping sorafenib in patients with hepatocellular carcinoma : NEXT score development and validation. / Lee, Hye Won; Kim, Hyun Soo; Kim, Seung Up; Kim, Do Young; Kim, Beom Kyung; Park, Jun Yong; Ahn, Sang Hoon; Jeon, Mi Young; Heo, Ja Yoon; Park, Soo Young; Lee, Yu Rim; Jang, Sun Kyung; Lee, Su Hyun; Jang, Se Young; Tak, Won Young; Han, Kwang Hyub.

In: Gut and liver, Vol. 11, No. 5, 09.2017, p. 693-701.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Survival estimates after stopping sorafenib in patients with hepatocellular carcinoma

T2 - NEXT score development and validation

AU - Lee, Hye Won

AU - Kim, Hyun Soo

AU - Kim, Seung Up

AU - Kim, Do Young

AU - Kim, Beom Kyung

AU - Park, Jun Yong

AU - Ahn, Sang Hoon

AU - Jeon, Mi Young

AU - Heo, Ja Yoon

AU - Park, Soo Young

AU - Lee, Yu Rim

AU - Jang, Sun Kyung

AU - Lee, Su Hyun

AU - Jang, Se Young

AU - Tak, Won Young

AU - Han, Kwang Hyub

PY - 2017/9

Y1 - 2017/9

N2 - 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.

AB - 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.

UR - http://www.scopus.com/inward/record.url?scp=85032027209&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85032027209&partnerID=8YFLogxK

U2 - 10.5009/gnl16391

DO - 10.5009/gnl16391

M3 - Article

C2 - 28651299

AN - SCOPUS:85032027209

VL - 11

SP - 693

EP - 701

JO - Gut and Liver

JF - Gut and Liver

SN - 1976-2283

IS - 5

ER -