A preoperative model to predict overall survival in patients with hepatoma undergoing resection

Background We aimed to develop a preoperative model to predict overall survival (OS) in patients with hepatoma undergoing liver resection (LR). Methods Patients who underwent LR for Barcelona Clinic Liver Cancer (BCLC) stage 0, A, or B hepatoma were enrolled. Tumor burden score (TBS) scores were determined using the following equation: TBS2 = (largest tumor size [in cm])2 + (tumor number)2. The cutoff values for radiographic TBS were based on our recently published paper: low, <2.6; medium, 2.6–7.9; high, >7.9. Results Multivariate analysis showed that radiographic TBS (low: referent; medium: HR = 2.89; 95% CI: 1.60–5.21; p < 0.001; high, HR = 7.60; 95% CI: 3.80–15.2; p < 0.001), AFP (<400 ng/mL: referent; ≧400 ng/mL: HR = 1.67, 95% CI: 1.11−2.52, p = 0.014), and cirrhosis (absence: referent; presence: HR = 1.88, 95% CI: 1.30–2.72, p < 0.001) were associated with OS. A simplified risk score was superior to BCLC system in concordance index (0.688 vs. 0.623). Conclusions We have developed a preoperative model that performs better in predicting OS than the BCLC system.