BALAD and BALAD-2 predict survival of hepatocellular carcinoma patients: a North American cohort study

Nicha Wongjarupong; Gabriela M. Negron-Ocasio; Kristin C. Mara; Kritika Prasai; Mohamed A. Abdallah; Keun Soo Ahn; Ju Dong Yang; Benyam D. Addissie; Nasra H. Giama; William S. Harmsen; Terry M. Therneau; Lewis R. Roberts

doi:10.1016/j.hpb.2020.09.014

BALAD and BALAD-2 predict survival of hepatocellular carcinoma patients: a North American cohort study

Nicha Wongjarupong, Gabriela M. Negron-Ocasio, Kristin C. Mara, Kritika Prasai, Mohamed A. Abdallah, Keun Soo Ahn, Ju Dong Yang, Benyam D. Addissie, Nasra H. Giama, William S. Harmsen, Terry M. Therneau, Lewis R. Roberts

Research output: Contribution to journal › Article › peer-review

8 Scopus citations

Abstract

Background: The BALAD score and BALAD-2 class derived from bilirubin, albumin, AFP, AFP-L3, and des-gamma-carboxyprothrombin (DCP) are effective in predicting mortality in HCC, but have not been validated in North America. Methods: 148 HCC patients from 2000 to 2015 who had all five biomarkers tested at diagnosis were included. Hazard ratios (HR) were calculated. Results: 75 patients died during a median follow-up of 21.9 months. 1-and 3-year survival rates were 70.8% and 47.6%. 114 (77%) had cirrhosis. The HR (95%CI) for death were 1.24 (0.42–3.67), 1.79 (0.61–5.26), 2.83 (0.95–8.38), and 7.19 (2.26–22.91) for BALAD scores 1, 2, 3, and 4 vs. BALAD 0. The HR (95%CI) for death were 1.25 (0.65–2.40), 1.75 (0.94–3.23), and 6.20 (3.29–11.68) for BALAD-2 classes 2, 3, and 4 vs. BALAD-2 class 1. A multivariate model incorporating maximal tumor diameter, tumor number, neutrophil-lymphocyte ratio, and BALAD had HR of 1.43 (1.14–1.81) per increase of 1 BALAD score. A similar model with BALAD-2 had HR of 1.50 (1.18–1.90) per increase of 1 BALAD-2 class. Conclusion: BALAD models at diagnosis can predict the survival of HCC patients in North America. AFP, AFP-L3, and DCP reflect tumor progression and metastasis of HCC and distinguish the BALAD model from other predictive models.

Original language	English (US)
Pages (from-to)	762-769
Number of pages	8
Journal	HPB
Volume	23
Issue number	5
DOIs	https://doi.org/10.1016/j.hpb.2020.09.014
State	Published - May 2021
Externally published	Yes

Bibliographical note

Funding Information:
Mayo Clinic Center for Clinical and Translational Science (CCATS), No. NCATS 1UL1TR002377-01; Mayo Clinic Center for Cell Signaling in Gastroenterology, No. NIDDK P30DK084567-09; Mayo Clinic Hepatobiliary SPORE, No. NCI P50CA210964; and Wako Life Sciences, Inc.

Publisher Copyright:
© 2020 International Hepato-Pancreato-Biliary Association Inc.

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access

10.1016/j.hpb.2020.09.014

OpenUrl availability

Full text

Cite this

@article{ebcd93078a954d01b9a390577667cc41,

title = "BALAD and BALAD-2 predict survival of hepatocellular carcinoma patients: a North American cohort study",

abstract = "Background: The BALAD score and BALAD-2 class derived from bilirubin, albumin, AFP, AFP-L3, and des-gamma-carboxyprothrombin (DCP) are effective in predicting mortality in HCC, but have not been validated in North America. Methods: 148 HCC patients from 2000 to 2015 who had all five biomarkers tested at diagnosis were included. Hazard ratios (HR) were calculated. Results: 75 patients died during a median follow-up of 21.9 months. 1-and 3-year survival rates were 70.8% and 47.6%. 114 (77%) had cirrhosis. The HR (95%CI) for death were 1.24 (0.42–3.67), 1.79 (0.61–5.26), 2.83 (0.95–8.38), and 7.19 (2.26–22.91) for BALAD scores 1, 2, 3, and 4 vs. BALAD 0. The HR (95%CI) for death were 1.25 (0.65–2.40), 1.75 (0.94–3.23), and 6.20 (3.29–11.68) for BALAD-2 classes 2, 3, and 4 vs. BALAD-2 class 1. A multivariate model incorporating maximal tumor diameter, tumor number, neutrophil-lymphocyte ratio, and BALAD had HR of 1.43 (1.14–1.81) per increase of 1 BALAD score. A similar model with BALAD-2 had HR of 1.50 (1.18–1.90) per increase of 1 BALAD-2 class. Conclusion: BALAD models at diagnosis can predict the survival of HCC patients in North America. AFP, AFP-L3, and DCP reflect tumor progression and metastasis of HCC and distinguish the BALAD model from other predictive models.",

author = "Nicha Wongjarupong and Negron-Ocasio, {Gabriela M.} and Mara, {Kristin C.} and Kritika Prasai and Abdallah, {Mohamed A.} and Ahn, {Keun Soo} and Yang, {Ju Dong} and Addissie, {Benyam D.} and Giama, {Nasra H.} and Harmsen, {William S.} and Therneau, {Terry M.} and Roberts, {Lewis R.}",

note = "Funding Information: Mayo Clinic Center for Clinical and Translational Science (CCATS), No. NCATS 1UL1TR002377-01; Mayo Clinic Center for Cell Signaling in Gastroenterology, No. NIDDK P30DK084567-09; Mayo Clinic Hepatobiliary SPORE, No. NCI P50CA210964; and Wako Life Sciences, Inc. Publisher Copyright: {\textcopyright} 2020 International Hepato-Pancreato-Biliary Association Inc.",

year = "2021",

month = may,

doi = "10.1016/j.hpb.2020.09.014",

language = "English (US)",

volume = "23",

pages = "762--769",

journal = "HPB",

issn = "1365-182X",

publisher = "John Wiley and Sons Inc.",

number = "5",

}

TY - JOUR

T1 - BALAD and BALAD-2 predict survival of hepatocellular carcinoma patients

T2 - a North American cohort study

AU - Wongjarupong, Nicha

AU - Negron-Ocasio, Gabriela M.

AU - Mara, Kristin C.

AU - Prasai, Kritika

AU - Abdallah, Mohamed A.

AU - Ahn, Keun Soo

AU - Yang, Ju Dong

AU - Addissie, Benyam D.

AU - Giama, Nasra H.

AU - Harmsen, William S.

AU - Therneau, Terry M.

AU - Roberts, Lewis R.

N1 - Funding Information: Mayo Clinic Center for Clinical and Translational Science (CCATS), No. NCATS 1UL1TR002377-01; Mayo Clinic Center for Cell Signaling in Gastroenterology, No. NIDDK P30DK084567-09; Mayo Clinic Hepatobiliary SPORE, No. NCI P50CA210964; and Wako Life Sciences, Inc. Publisher Copyright: © 2020 International Hepato-Pancreato-Biliary Association Inc.

PY - 2021/5

Y1 - 2021/5

N2 - Background: The BALAD score and BALAD-2 class derived from bilirubin, albumin, AFP, AFP-L3, and des-gamma-carboxyprothrombin (DCP) are effective in predicting mortality in HCC, but have not been validated in North America. Methods: 148 HCC patients from 2000 to 2015 who had all five biomarkers tested at diagnosis were included. Hazard ratios (HR) were calculated. Results: 75 patients died during a median follow-up of 21.9 months. 1-and 3-year survival rates were 70.8% and 47.6%. 114 (77%) had cirrhosis. The HR (95%CI) for death were 1.24 (0.42–3.67), 1.79 (0.61–5.26), 2.83 (0.95–8.38), and 7.19 (2.26–22.91) for BALAD scores 1, 2, 3, and 4 vs. BALAD 0. The HR (95%CI) for death were 1.25 (0.65–2.40), 1.75 (0.94–3.23), and 6.20 (3.29–11.68) for BALAD-2 classes 2, 3, and 4 vs. BALAD-2 class 1. A multivariate model incorporating maximal tumor diameter, tumor number, neutrophil-lymphocyte ratio, and BALAD had HR of 1.43 (1.14–1.81) per increase of 1 BALAD score. A similar model with BALAD-2 had HR of 1.50 (1.18–1.90) per increase of 1 BALAD-2 class. Conclusion: BALAD models at diagnosis can predict the survival of HCC patients in North America. AFP, AFP-L3, and DCP reflect tumor progression and metastasis of HCC and distinguish the BALAD model from other predictive models.

AB - Background: The BALAD score and BALAD-2 class derived from bilirubin, albumin, AFP, AFP-L3, and des-gamma-carboxyprothrombin (DCP) are effective in predicting mortality in HCC, but have not been validated in North America. Methods: 148 HCC patients from 2000 to 2015 who had all five biomarkers tested at diagnosis were included. Hazard ratios (HR) were calculated. Results: 75 patients died during a median follow-up of 21.9 months. 1-and 3-year survival rates were 70.8% and 47.6%. 114 (77%) had cirrhosis. The HR (95%CI) for death were 1.24 (0.42–3.67), 1.79 (0.61–5.26), 2.83 (0.95–8.38), and 7.19 (2.26–22.91) for BALAD scores 1, 2, 3, and 4 vs. BALAD 0. The HR (95%CI) for death were 1.25 (0.65–2.40), 1.75 (0.94–3.23), and 6.20 (3.29–11.68) for BALAD-2 classes 2, 3, and 4 vs. BALAD-2 class 1. A multivariate model incorporating maximal tumor diameter, tumor number, neutrophil-lymphocyte ratio, and BALAD had HR of 1.43 (1.14–1.81) per increase of 1 BALAD score. A similar model with BALAD-2 had HR of 1.50 (1.18–1.90) per increase of 1 BALAD-2 class. Conclusion: BALAD models at diagnosis can predict the survival of HCC patients in North America. AFP, AFP-L3, and DCP reflect tumor progression and metastasis of HCC and distinguish the BALAD model from other predictive models.

UR - http://www.scopus.com/inward/record.url?scp=85092013544&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85092013544&partnerID=8YFLogxK

U2 - 10.1016/j.hpb.2020.09.014

DO - 10.1016/j.hpb.2020.09.014

M3 - Article

C2 - 33023823

AN - SCOPUS:85092013544

SN - 1365-182X

VL - 23

SP - 762

EP - 769

JO - HPB

JF - HPB

IS - 5

ER -

BALAD and BALAD-2 predict survival of hepatocellular carcinoma patients: a North American cohort study

Abstract

Bibliographical note

UN SDGs

Access

OpenUrl availability

Other files and links

Fingerprint

Cite this