Prognostic Index of Ikai et al for a Hepatocellular Carcinoma with a Tumor Thrombus in a Major Portal Vein

Description

Ikai et al developed a prognostic index for evaluating a patient with hepatocellular carcinoma and tumor extension into a major portal vein. This can help identify a patient who may benefit from more aggressive management or who may be a candidate for novel therapies or liver transplantation. The authors are from Kyoto University.

Parameters:

(1) ascites

(2) prothrombin activity

(3) maximal tumor diameter in centimeters

Parameter	Finding	Points
ascites	absent	0
	present	1
prothrombin activity	>= 75%	0
	< 75%	1
maximal diameter	< 5 cm	0
	>= 5 cm	1

where:

• The prothrombin activity is not readily available in the US. A dilution curve can be run against the PT (using plasma deficient in prothrombin complex), but a quick and dirty fix would be to assign a point if the prothrombin time is prolonged.

prognostic index =

= SUM(points for all 3 parameters)

Interpretation:

• minimum index: 0

• maximum index: 3

• The higher the index the worse the prognosis.

Index	Median Survival
0	5.6 years
1	1.6 years
2	0.5 years
3	0.1 years

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Description

Specialty

ICD-10