Evidence map›Paper›PMID 29121890›Full record

ArticleBMC cancer2017

RAM score is an effective predictor for early mortality and recurrence after hepatectomy for hepatocellular carcinoma.

Heng-Yuan Hsu, Ming-Chin Yu, Chao-Wei Lee, Hsin-I Tsai, Chang-Mu Sung, Chun-Wei Chen, Shu-Wei Huang, Cheng-Yu Lin, Wen-Juei Jeng, Wei-Chen Lee and 1 more

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Article in BMC cancer, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
21citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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3 · Its place in the literature

Who cites it

21 citing papers in PubMed, 2 syntheses or guidelines pooled it.

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4 · The record

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PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Heng-Yuan HsuDepartment of Surgery, Chang Gung Memorial Hospital, No. 5, Fuxing St., Guishan Dist., Taoyuan, 333, Taiwan, Republic of China.
Ming-Chin YuDepartment of Surgery, Chang Gung Memorial Hospital, No. 5, Fuxing St., Guishan Dist., Taoyuan, 333, Taiwan, Republic of China.
Chao-Wei LeeDepartment of Surgery, Chang Gung Memorial Hospital, No. 5, Fuxing St., Guishan Dist., Taoyuan, 333, Taiwan, Republic of China. alanchaoweilee@hotmail.com.
Hsin-I TsaiGraduate Institute of Clinical Medical Sciences, Chang Gung University, Taoyuan, Taiwan, Republic of China.
Chang-Mu SungGraduate Institute of Clinical Medical Sciences, Chang Gung University, Taoyuan, Taiwan, Republic of China.
Chun-Wei ChenDepartment of Gastroenterology and Hepatology, Chang Gung Memorial Hospital, No. 5, Fuxing St., Guishan Dist., Taoyuan, 333, Taiwan, Republic of China.
Shu-Wei HuangDepartment of Gastroenterology and Hepatology, Chang Gung Memorial Hospital, No. 5, Fuxing St., Guishan Dist., Taoyuan, 333, Taiwan, Republic of China.
Cheng-Yu LinDepartment of Gastroenterology and Hepatology, Chang Gung Memorial Hospital, No. 5, Fuxing St., Guishan Dist., Taoyuan, 333, Taiwan, Republic of China.
Wen-Juei JengDepartment of Gastroenterology and Hepatology, Chang Gung Memorial Hospital, No. 5, Fuxing St., Guishan Dist., Taoyuan, 333, Taiwan, Republic of China.
Wei-Chen LeeDepartment of Surgery, Chang Gung Memorial Hospital, No. 5, Fuxing St., Guishan Dist., Taoyuan, 333, Taiwan, Republic of China.
Miin-Fu ChenDepartment of Surgery, Chang Gung Memorial Hospital, No. 5, Fuxing St., Guishan Dist., Taoyuan, 333, Taiwan, Republic of China.

Funding

Chang Gung Memorial Hospital, Linkou CMRPG3C0951-3
6 · The paper itself

Abstract

backgroundLiver resection had been regarded as a standard treatment for primary hepatocellular carcinoma (HCC). However, early mortality and recurrence after surgery were still of major concern. RAM (Risk Assessment for early Mortality) scoring system is a newly developed tool for assessing early mortality after hepatectomy for HCC. In this study, we compared RAM scoring system with ALBI and MELD scores for their capability of predicting short-term outcome.

methodsWe retrospectively reviewed patients with hepatocellular carcinoma who were treated with hepatectomy at Chang Gung Memorial Hospital between 1986 and 2015. Their clinical characteristics and perioperative variables were collected. We applied RAM, albumin-bilirubin (ALBI), and model for end-stage liver disease (MELD) scoring systems to predict early mortality and early recurrence in HCC patients after surgery. We investigated the discriminative power of each scoring system by receiver operating characteristic (ROC) curve and area under the ROC curve (AUC).

resultsA total of 1935 patients (78% male) who underwent liver resection for HCC were included in this study. The median follow-up period was 41.9 months. One hundred and forty-nine patients (7.7%) died within 6 months after hepatectomy (early mortality). All the three scoring systems were effective predictor for early mortality, with higher score indicating higher risk of early mortality (AUC of RAM = 0.723, p < 0.001; AUC of ALBI = 0.682, p < 0.001; AUC of MELD = 0.590, p = 0.002). Cox regression multivariate analysis demonstrated that the RAM class was the most significant independent predictor of early mortality after surgery, while MELD grade failed to discriminatively predict early mortality. In addition to early mortality, the RAM score was also predictive of early recurrence in HCC after surgery.

conclusionsThis study demonstrated that RAM score is an effective and user-friendly bedside scoring system to predict early mortality and early recurrence after hepatectomy for HCC. In addition, the predictive capability of RAM score is superior to ALBI and MELD scores. Further study is warranted to validate our findings.

Indexed as

AgedCarcinoma, HepatocellularFemaleHepatectomyHumansLiver NeoplasmsMaleMiddle AgedMortalityNeoplasm Recurrence, LocalPrognosisRetrospective StudiesRisk AssessmentEarly mortalityEarly recurrenceHepatectomyHepatocellular carcinomaHepatomaLiver resectionRAM scoreShort term outcome

Identifiers

PMID29121890
PMCPMC5680811

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.