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V-CLIP: Integrating plasma vascular endothelial growth factor into a new scoring system to stratify patients with advanced hepatocellular carcinoma for clinical trials.

Publication ,  Journal Article
Kaseb, AO; Hassan, MM; Lin, E; Xiao, L; Kumar, V; Pathak, P; Lozano, R; Rashid, A; Abbruzzese, JL; Morris, JS
Published in: Cancer
June 1, 2011

BACKGROUND: Several staging systems have been proposed for hepatocellular carcinoma (HCC); however, none has incorporated circulating angiogenic biomarkers. The purpose of this study was to determine whether vascular endothelial growth factor (VEGF) could independently predict overall survival in patients with HCC, and whether adding VEGF level into the Cancer of the Liver Italian Program (CLIP) score could improve patient stratification and prediction of overall survival. METHODS: Between 2001 and 2008, baseline plasma VEGF levels were available from 288 patients, and multivariate Cox regression models and median survival (95% confidence intervals) were calculated. Recursive partitioning was used to determine the optimal cutpoint for VEGF, using 10 repeated training/validation samples, each using two-thirds of the data to determine the best cutpoint and the remaining one-third to validate it. Prognostic ability of CLIP and V-CLIP was compared using the concordence index. RESULTS: Plasma VEGF was a significant independent predictor of overall survival, with an optimal VEGF cutpoint of 450 pg/mL. After CLIP validation in our patients, we added VEGF to the CLIP score and found that the new V-CLIP score better separates patients into homogenous prognostic groups (P = .005). CONCLUSIONS: The assessment of baseline plasma VEGF levels increases the precision of the CLIP scoring system for predicting HCC prognosis, which may assist in equally randomizing patients with HCC in clinical trials. Prospective validation of the V-CLIP scoring system is warranted.

Duke Scholars

Published In

Cancer

DOI

EISSN

1097-0142

Publication Date

June 1, 2011

Volume

117

Issue

11

Start / End Page

2478 / 2488

Location

United States

Related Subject Headings

  • Vascular Endothelial Growth Factor A
  • Risk Factors
  • Risk
  • Reproducibility of Results
  • Prognosis
  • Oncology & Carcinogenesis
  • Middle Aged
  • Male
  • Liver Neoplasms
  • Humans
 

Citation

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Kaseb, A. O., Hassan, M. M., Lin, E., Xiao, L., Kumar, V., Pathak, P., … Morris, J. S. (2011). V-CLIP: Integrating plasma vascular endothelial growth factor into a new scoring system to stratify patients with advanced hepatocellular carcinoma for clinical trials. Cancer, 117(11), 2478–2488. https://doi.org/10.1002/cncr.25791
Kaseb, Ahmed O., Manal M. Hassan, E. Lin, Lianchun Xiao, Vikas Kumar, Priyanka Pathak, Richard Lozano, Asif Rashid, James L. Abbruzzese, and Jeffrey S. Morris. “V-CLIP: Integrating plasma vascular endothelial growth factor into a new scoring system to stratify patients with advanced hepatocellular carcinoma for clinical trials.Cancer 117, no. 11 (June 1, 2011): 2478–88. https://doi.org/10.1002/cncr.25791.
Kaseb, Ahmed O., et al. “V-CLIP: Integrating plasma vascular endothelial growth factor into a new scoring system to stratify patients with advanced hepatocellular carcinoma for clinical trials.Cancer, vol. 117, no. 11, June 2011, pp. 2478–88. Pubmed, doi:10.1002/cncr.25791.
Kaseb AO, Hassan MM, Lin E, Xiao L, Kumar V, Pathak P, Lozano R, Rashid A, Abbruzzese JL, Morris JS. V-CLIP: Integrating plasma vascular endothelial growth factor into a new scoring system to stratify patients with advanced hepatocellular carcinoma for clinical trials. Cancer. 2011 Jun 1;117(11):2478–2488.
Journal cover image

Published In

Cancer

DOI

EISSN

1097-0142

Publication Date

June 1, 2011

Volume

117

Issue

11

Start / End Page

2478 / 2488

Location

United States

Related Subject Headings

  • Vascular Endothelial Growth Factor A
  • Risk Factors
  • Risk
  • Reproducibility of Results
  • Prognosis
  • Oncology & Carcinogenesis
  • Middle Aged
  • Male
  • Liver Neoplasms
  • Humans