The clinical prognostic risk stratification system for HIV infected hepatocellular carcinoma - 19/10/24

Doi : 10.1016/j.clinre.2024.102479

Yifan Chen ^1,^2,^{^{#
Yifan Che, Han Zhao, and Yao Wang enjoyed joint contributions to this paper.}}, Han Zhao ^3,^{^{#
Yifan Che, Han Zhao, and Yao Wang enjoyed joint contributions to this paper.}}, Yao Wang ^2,^{^{#
Yifan Che, Han Zhao, and Yao Wang enjoyed joint contributions to this paper.}}, Bo Liu ³, Zhimin Chen ³, Yu Tao ¹, Yang Xun ⁴, Hua Yang ⁴, Rongqiu Liu ¹, Lizhi Feng ³, Xinhua Liu ³, Hengjing Li ³, Sibo Wang ³, Baolin Liao ³, Dong Zhao ^5,^⁎ , Haolan He ^3,^⁎ , Hua You ^1,^2,^⁎
¹ Laboratory for Excellence in Systems Biomedicine of Pediatric Oncology, Department of Pediatric Hematology and Oncology, Chongqing Key Laboratory of Pediatric Metabolism and Inflammatory Diseases, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, Children's Hospital of Chongqing Medical University, Chongqing, China
² Department of Oncology, Affiliated Cancer Hospital & Institute of Guangzhou Medical University, Guangzhou, China
³ Infectious Diseases Center, Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou, China
⁴ Department of Basic Medicine and Biomedical Engineering, School of Medicine, Foshan University, Foshan, China
⁵ Department of Liver Surgery and Organ Transplantation Center, Shenzhen Third People's Hospital, Second Affiliated Hospital, Southern University of Science and Technology, Shenzhen, Guangdong, China

^⁎Corresponding Authors: Hua You, Laboratory for Excellence in Systems Biomedicine of Pediatric Oncology, Department of Pediatric Hematology and Oncology, Chongqing Key Laboratory of Pediatric Metabolism and Inflammatory Diseases, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, Children's Hospital of Chongqing Medical University, Chongqing, 401122, ChinaLaboratory for Excellence in Systems Biomedicine of Pediatric OncologyDepartment of Pediatric Hematology and OncologyChongqing Key Laboratory of Pediatric Metabolism and Inflammatory DiseasesMinistry of Education Key Laboratory of Child Development and DisordersNational Clinical Research Center for Child Health and DisordersChildren's Hospital of Chongqing Medical UniversityChongqing401122China^⁎⁎Corresponding Authors: Haolan He, Infectious Diseases Center, Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou, 510000, ChinaInfectious Diseases CenterGuangzhou Eighth People's HospitalGuangzhou Medical UniversityGuangzhou510000China^⁎⁎⁎Corresponding Authors: Dong Zhao, Department of Liver Surgery and Organ Transplantation Center, Shenzhen Third People's Hospital, Second Affiliated Hospital, Southern University of Science and Technology, Shenzhen, Guangdong, 518112, ChinaDepartment of Liver Surgery and Organ Transplantation CenterShenzhen Third People's HospitalSecond Affiliated HospitalSouthern University of Science and TechnologyShenzhenGuangdong518112China

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Highlights

•	Develop the inaugural predictive model that accurately and objectively forecasts the overall survival (OS) of HIV-coinfected hepatocellular carcinoma (HCC) patients.
•	Predictive model is designed for integration into routine clinical practice to aid in decision-making processes.
•	Model serves as a guide for monitoring clinical prognosis in HIV-positive HCC patients, and enhancing their survival rates.

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Abstract

Background

Patients with human immunodeficiency virus (HIV) are more susceptible to liver cancer because of their compromised immune system. There is no specific prognostic model for HIV-infected hepatocellular carcinoma (HCC) patients.

Methods

Clinical data of 85 patients with HIV-infected HCC was divided into a 7:3 ratio for training and internal validation sets, while the data of 23 patients with HIV-infected HCC was served as the external validation set. Data of 275 HIV-negative HCC patients was considered as external HIV-negative validation set. Variables associated with overall survival (OS) in the training set were used to develop the HIV-infected HCC prognosis (HIHP) model. The model was tested in the internal and external validation sets. The predictive accuracy of the model was assessed with conventional HIV-negative HCC prognostic scoring systems.

Results

In the training set, variables independently associated with OS in multivariable analysis were organ involvement and tumor number. The HIHP model demonstrated a significant association with OS in the training set, with a median OS of 13 months for low risk, 7 months for medium risk, and 3 months for high risk (p < 0.001). The HIHP model showed a significant association with OS, and exhibited greater discriminative abilities compared to conventional HIV-negative HCC prognostic models both in the internal and external validation sets. In the external HIV-negative validation set, the HIHP model did not show better discrimination than conventional HIV-negative HCC scores.

Conclusion

The new model presented in the work provided a more accurate prognostic prediction of OS in HIV-infected HCC patients. However, the model is not applicable to patients with HIV-negative HCC.

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Keywords : human immunodeficiency virus-infected hepatocellular carcinoma, prognostic model, risk stratification, organ involvement, tumor number