Model for end-stage liver disease and sodium velocity predicts overall survival in nonmetastatic hepatocellular carcinoma patients

Research output: Contribution to journalArticle

Abstract

Background & Aims. The significance of short-term changes in model for end-stage liver disease and Sodium (MELD-Na) following hepatocellular carcinoma (HCC) diagnosis is unknown. In this report, we explore the value of the rate of short-term changes in MELD-Na as an independent predictor of mortality in patients with nonmetastatic HCC. Methods. We reviewed a cohort of patients diagnosed with nonmetastatic HCC at our institution between 2001 and 2011. We evaluated potential predictors of overall survival, including baseline MELD-Na and the change in MELD-Na over 90 days. We explored survival times of cohorts grouped by baseline MELD-Na and the change in MELD-Na. Results. 182 patients met eligibility criteria. With a median follow-up of 21 months for surviving patients, 110 deaths were observed (60%). Median MELD-Na at the time of diagnosis was 9.7 (IQR 7.5 to 13.9). The median changes in percentage of MELD-Na over 90 days were an increase of 9% (IQR -4% to 55%). Multivariable Cox proportional hazards modeling demonstrated that both baseline MELD-Na (HR=1.07 per unit increase, 95% CI 1.03 to 1.11, p<0.001) and changes in MELD-Na exceeding 40% (HR=3.69, 95% CI 2.39 to 5.69, p<0.001) were independently associated with increased mortality risk. Median survival among patients whose changes in MELD-Na were greater than 40% was 4.5 months, and median survival among the 131 other patients was 25.8 months (p<0.001). Conclusions. We identified a subset of HCC patients who have extremely poor prognosis by incorporating the rate of short-term change in MELD-Na to baseline MELD-Na score.

Original languageEnglish (US)
Article number5681979
JournalCanadian Journal of Gastroenterology and Hepatology
Volume2018
DOIs
StatePublished - Jan 1 2018

Fingerprint

End Stage Liver Disease
Hepatocellular Carcinoma
Sodium
Survival
Mortality

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

Cite this

@article{311e271500bb4fd3b90d54a006588922,
title = "Model for end-stage liver disease and sodium velocity predicts overall survival in nonmetastatic hepatocellular carcinoma patients",
abstract = "Background & Aims. The significance of short-term changes in model for end-stage liver disease and Sodium (MELD-Na) following hepatocellular carcinoma (HCC) diagnosis is unknown. In this report, we explore the value of the rate of short-term changes in MELD-Na as an independent predictor of mortality in patients with nonmetastatic HCC. Methods. We reviewed a cohort of patients diagnosed with nonmetastatic HCC at our institution between 2001 and 2011. We evaluated potential predictors of overall survival, including baseline MELD-Na and the change in MELD-Na over 90 days. We explored survival times of cohorts grouped by baseline MELD-Na and the change in MELD-Na. Results. 182 patients met eligibility criteria. With a median follow-up of 21 months for surviving patients, 110 deaths were observed (60{\%}). Median MELD-Na at the time of diagnosis was 9.7 (IQR 7.5 to 13.9). The median changes in percentage of MELD-Na over 90 days were an increase of 9{\%} (IQR -4{\%} to 55{\%}). Multivariable Cox proportional hazards modeling demonstrated that both baseline MELD-Na (HR=1.07 per unit increase, 95{\%} CI 1.03 to 1.11, p<0.001) and changes in MELD-Na exceeding 40{\%} (HR=3.69, 95{\%} CI 2.39 to 5.69, p<0.001) were independently associated with increased mortality risk. Median survival among patients whose changes in MELD-Na were greater than 40{\%} was 4.5 months, and median survival among the 131 other patients was 25.8 months (p<0.001). Conclusions. We identified a subset of HCC patients who have extremely poor prognosis by incorporating the rate of short-term change in MELD-Na to baseline MELD-Na score.",
author = "Tang, {Justin Y.} and Nitin Ohri and Rafi Kabarriti and Santiago Aparo and Chuy, {Jennifer W.} and Sanjay Goel and Schwartz, {Jonathan M.} and Milan Kinkhabwala and Andreas Kaubisch and Chandan Guha",
year = "2018",
month = "1",
day = "1",
doi = "10.1155/2018/5681979",
language = "English (US)",
volume = "2018",
journal = "Canadian Journal of Gastroenterology and Hepatology",
issn = "2291-2789",
publisher = "Pulsus Group Inc.",

}

TY - JOUR

T1 - Model for end-stage liver disease and sodium velocity predicts overall survival in nonmetastatic hepatocellular carcinoma patients

AU - Tang, Justin Y.

AU - Ohri, Nitin

AU - Kabarriti, Rafi

AU - Aparo, Santiago

AU - Chuy, Jennifer W.

AU - Goel, Sanjay

AU - Schwartz, Jonathan M.

AU - Kinkhabwala, Milan

AU - Kaubisch, Andreas

AU - Guha, Chandan

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Background & Aims. The significance of short-term changes in model for end-stage liver disease and Sodium (MELD-Na) following hepatocellular carcinoma (HCC) diagnosis is unknown. In this report, we explore the value of the rate of short-term changes in MELD-Na as an independent predictor of mortality in patients with nonmetastatic HCC. Methods. We reviewed a cohort of patients diagnosed with nonmetastatic HCC at our institution between 2001 and 2011. We evaluated potential predictors of overall survival, including baseline MELD-Na and the change in MELD-Na over 90 days. We explored survival times of cohorts grouped by baseline MELD-Na and the change in MELD-Na. Results. 182 patients met eligibility criteria. With a median follow-up of 21 months for surviving patients, 110 deaths were observed (60%). Median MELD-Na at the time of diagnosis was 9.7 (IQR 7.5 to 13.9). The median changes in percentage of MELD-Na over 90 days were an increase of 9% (IQR -4% to 55%). Multivariable Cox proportional hazards modeling demonstrated that both baseline MELD-Na (HR=1.07 per unit increase, 95% CI 1.03 to 1.11, p<0.001) and changes in MELD-Na exceeding 40% (HR=3.69, 95% CI 2.39 to 5.69, p<0.001) were independently associated with increased mortality risk. Median survival among patients whose changes in MELD-Na were greater than 40% was 4.5 months, and median survival among the 131 other patients was 25.8 months (p<0.001). Conclusions. We identified a subset of HCC patients who have extremely poor prognosis by incorporating the rate of short-term change in MELD-Na to baseline MELD-Na score.

AB - Background & Aims. The significance of short-term changes in model for end-stage liver disease and Sodium (MELD-Na) following hepatocellular carcinoma (HCC) diagnosis is unknown. In this report, we explore the value of the rate of short-term changes in MELD-Na as an independent predictor of mortality in patients with nonmetastatic HCC. Methods. We reviewed a cohort of patients diagnosed with nonmetastatic HCC at our institution between 2001 and 2011. We evaluated potential predictors of overall survival, including baseline MELD-Na and the change in MELD-Na over 90 days. We explored survival times of cohorts grouped by baseline MELD-Na and the change in MELD-Na. Results. 182 patients met eligibility criteria. With a median follow-up of 21 months for surviving patients, 110 deaths were observed (60%). Median MELD-Na at the time of diagnosis was 9.7 (IQR 7.5 to 13.9). The median changes in percentage of MELD-Na over 90 days were an increase of 9% (IQR -4% to 55%). Multivariable Cox proportional hazards modeling demonstrated that both baseline MELD-Na (HR=1.07 per unit increase, 95% CI 1.03 to 1.11, p<0.001) and changes in MELD-Na exceeding 40% (HR=3.69, 95% CI 2.39 to 5.69, p<0.001) were independently associated with increased mortality risk. Median survival among patients whose changes in MELD-Na were greater than 40% was 4.5 months, and median survival among the 131 other patients was 25.8 months (p<0.001). Conclusions. We identified a subset of HCC patients who have extremely poor prognosis by incorporating the rate of short-term change in MELD-Na to baseline MELD-Na score.

UR - http://www.scopus.com/inward/record.url?scp=85057006997&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85057006997&partnerID=8YFLogxK

U2 - 10.1155/2018/5681979

DO - 10.1155/2018/5681979

M3 - Article

VL - 2018

JO - Canadian Journal of Gastroenterology and Hepatology

JF - Canadian Journal of Gastroenterology and Hepatology

SN - 2291-2789

M1 - 5681979

ER -