The MELD-Na is an independent short- and long-term prognostic predictor for hepatocellular carcinoma: A prospective survey

• Published in: Digestive and liver disease 2008-11, Vol.40 (11), p.882-889
• Main Authors: Huo, T.-I, Lin, H.-C, Hsia, C.-Y, Huang, Y.-H, Wu, J.-C, Chiang, J.-H, Chiou, Y.-Y, Lui, W.-Y, Lee, P.-C, Lee, S.-D
• Format: Article
• Language: English
• Subjects: Aged; Biomarkers, Tumor - blood; Carcinoma, Hepatocellular - blood; Carcinoma, Hepatocellular - mortality; Cause of Death; Cohort Studies; Female; Gastroenterology and Hepatology; Hepatocellular carcinoma; Humans; Liver cirrhosis; Liver Failure - blood; Liver Failure - mortality; Liver Neoplasms - blood; Liver Neoplasms - mortality; Logistic Models; Male; MELD; MELD-Na; Middle Aged; Multivariate Analysis; Predictive Value of Tests; Prognosis; Proportional Hazards Models; Prospective Studies; Sensitivity and Specificity; Sodium - blood; Survival Analysis; Time Factors
• ISSN: 1590-8658; 1878-3562
• DOI: 10.1016/j.dld.2008.01.015

Abstract Background and aim Serum sodium has been suggested to incorporate into the model for end-stage liver disease to enhance its prognostic ability for cirrhosis. A mathematical equation based on model for end-stage liver disease and sodium, known as “MELD-Na”, was developed for outcome prediction for cirrhosis. The severity of liver cirrhosis is a key component to predict survival in patients with hepatocellular carcinoma. This study investigated the prognostic role of MELD-Na for hepatocellular carcinoma. Patients and methods A total of 535 unselected hepatocellular carcinoma patients were prospectively enrolled to evaluate the performance of MELD-Na. Results The MELD-Na was better than model for end-stage liver disease in predicting 6-month mortality by comparing the area under receiver operating characteristic curve (0.782 vs. 0.761, p = 0.101). MELD-Na, but not model for end-stage liver disease, was an independent predictor associated with 6-month mortality in multivariate logistic regression analysis (odds ratio: 1.14, p = 0.001). In the survival analysis, MELD-Na also independently predicted mortality, with an additional risk of 4.3% per unit increment of the score ( p < 0.001). Patients with MELD-Na scores between 10 and 20 and scores >20 had 2.1-fold ( p < 0.001) and 7.5-fold ( p < 0.001) risk of mortality, respectively, compared to patients with a score