Survival Estimates after Stopping Sorafenib in Patients with Hepatocellular Carcinoma: NEXT Score Development and Validation

• Published in: Gut and liver 2017-09, Vol.11 (5), p.693
• Main Authors: 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
• Format: Article
• Language: Korean
• Subjects: Hepatocellular carcinoma; Prediction; Risk; Sorafenib; Survival
• ISSN: 1976-2283

Background/Aims: Limited information is available regard-ing 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 tak-ing 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 Coopera-tive 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