Description

Lauwers et al developed a Hepatocellular Prognostic Index (HPI) for patients with hepatocellular carcinomas that can be completely resected. This can help identify whether a patient will have a fair or poor prognosis. The authors are from the International Cooperative Study Group on Hepatocellular Carcinoma from academic medical institutions in the United States, Europe and Japan.


 

Parameters:

(1) microvascular invasion status

(2) nuclear grade

Parameter

Finding

Points

microvascular invasion

present (tumor seen invading small blood vessels)

1

 

absent

0

nuclear grade

similar to benign nuclei with little variation in size and shape

1

 

larger with mild to moderate pleomorphism; nucleoli are prominent and chromatin clumping is present

2

 

large, highly pleomorphic nuclei with prominent nucleoli

3

 

HPI =

= (0.459 * (points for microvascular invasion status)) + (0.287 * (points for nuclear grade))

 

Interpretation:

• minimum score: 0

• maximum score: 1.32

• The cut-off value for separating fair from poor prognostic groups was 0.746.

 

HPI

Prognostic Group

50% Survival

<= 0.746

fair

5.06 years

> 0.746

poor

2.71 years

 


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