Development of a prognostic scoring system for hepatic vena cava Budd-Chiari syndrome with hepatocellular carcinoma
Sheng-Yan Liu a , b , Lu-Hao Li a , b , Zhao-Chen Liu a , b , Su-Xin Li a , b , Xiao-Wei Dang a , b , ∗
a Department of Hepatopancreatobiliary Surgery, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
b Budd-Chiari Syndrome Diagnosis and Treatment Center of Henan Province, Zhengzhou 450052, China
∗Corresponding author at: Department of Hepatopancreatobiliary Surgery, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China. E-mail address: dangxw1001@zzu.edu.cn (X.-W. Dang).
Abstract：Background: Hepatocellular carcinoma (HCC) is a serious complication of hepatic vena cava Budd-Chiari syndrome (HVC-BCS) that significantly reduces the survival time of patients. Our study aimed to analyze the prognostic factors influencing the survival of HVC-BCS patients with HCC and to develop a prognostic scoring system.
Methods: The clinical and follow-up data of 64 HVC-BCS patients with HCC who received invasive treat- ment at the First Affiliated Hospital of Zhengzhou University between January 2015 and December 2019 were retrospectively analyzed. Kaplan-Meier curves and log-rank tests were used to analyze the survival curve of patients and the difference in prognoses between the groups. Univariate and multivariate Cox regression analyses were performed to analyze the influence of biochemical, tumor, and etiological characteristics on the total survival time of patients, and a new prognostic scoring system was developed according to the regression coefficients of the independent predictors in the statistical model. The prediction efficiency was evaluated using the time-dependent receiver operating characteristics curve and concordance index.
Results: Multivariate analysis showed that serum albumin level < 34 g/L [hazard ratio (HR) = 4.207, 95% confidence interval (CI): 1.816-8.932, P = 0.001], maximum tumor diameter > 7 cm (HR = 8.623, 95% CI: 3.771-19.715, P < 0.001), and inferior vena cava stenosis (HR = 3.612, 95% CI: 1.646-7.928, P = 0.001) were independent predictors of survival. A prognostic scoring system was developed according to the above-mentioned independent predictors, and patients were classified into grades A, B, C and D. Significant differences in survival were found among the four groups.
Conclusions: This study successfully developed a prognostic scoring system for HVC-BCS patients with HCC, which is helpful for clinical evaluation of patient prognosis.
. [J]. Hepatobiliary Pancreat Dis Int, 2024, 23(4): 370-375.
Liu SY, Li LH, Liu ZC, Li SX, Dang XW. Development of a prognostic scoring system for hepatic vena cava Budd-Chiari syndrome with hepatocellular carcinoma. Hepatobiliary Pancreat Dis Int, 2024, 23(4): 370-375.
2024, Vol. 23 
