Clinical Significance of the Up-To-Seven Score for the Assessment of the Tumor Stage in Patients with Hepatocellular Carcinoma

Jung, Chang Ho; Seo, Yeon Seok; Lee, Jae Min; Yoon, Seok Bae; Yun, Tae Jung; Yim, Sun Young; An, Hyong gin; Um, Soon Ho; Kim, Chang Duck; Ryu, Ho Sang

doi:2014.14.1.14

J Liver Cancer > Volume 14(1); 2014 > Article

Original Article

Journal of the Korean Liver Cancer Study Group 2014;14(1):14-22.
DOI: https://doi.org/10.17998/jlc.14.1.14 Published online March 31, 2014.

Clinical Significance of the Up-To-Seven Score for the Assessment of the Tumor Stage in Patients with Hepatocellular Carcinoma

Chang Ho Jung, Yeon Seok Seo¹, Jae Min Lee¹, Seok Bae Yoon¹, Tae Jung Yun¹, Sun Young Yim¹, Hyong gin An², Soon Ho Um¹, Chang Duck Kim¹, Ho Sang Ryu¹

¹Division of Gastroenterology and Hepatology, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
²Biostatistics, Korea University College of Medicine, Seoul, Korea

Abstract

Background/Aims
Up-to-seven criteria was proven to be useful for predicting prognosis after liver transplantation in patients with hepatocellular carcinoma (HCC). The aim of this study was to evaluate that up-to-seven score could be useful method for prediction of prognosis in patients with HCC who did not undergo liver transplantation.
Methods
Between January 2006 and December 2008, 216 HCC patients without vascular invasion, lymph node and distant metastasis were analyzed retrospectively. We investigated the prognostic impact of laboratory findings, clinical characteristics, modified UICC T stage, and up-to-seven score in HCC. The survival analyses were performed using Kaplan-Meier method and Cox-regression analysis.
Results
Two-hundred sixteen patients with HCC were included. Age was 60.1±11.3 years and 74.5% were male. Chronic hepatitis B was the most common cause of liver disease (60.6%). T stage was T1, T2, and T3 in 36 (16.7%), 118 (54.6%), and 62 (28.7%) patients, respectively. Up-to-even score was 5.5±4.0 and it was <3 (UTS 1), ≥3 and ≤7 (UTS 2), and >7 (UTS 3) in 36 (16.7%), 133 (61.6%), and 47 (21.8%) patients, respectively. The 10 (8.5%) patients of T2 stage were classified into UTS 3 and 25 (40.3%) patients of T3 stage were classified into UTS 2. The prognosis was significantly different in patients with T2 or T3 according to their UTS. Multivariate analysis showed that Child-Pugh score and UTS were significantly associated factors with survival.
Conclusions
Up-to-seven score was useful to predict prognosis and to evaluate tumor stage in patients without vascular invasion, lymph node and distant metastasis.

Key Words: Hepatocellular carcinoma; Up-to-seven score; Survival; Prognosis

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