Volume 145, Issue 1, Pages 176-187 (July 2013) A Hepatocellular Carcinoma 5-Gene Score Associated With Survival of Patients After Liver Resection  Jean–Charles Nault, Aurélien De Reyniès, Augusto Villanueva, Julien Calderaro, Sandra Rebouissou, Gabrielle Couchy, Thomas Decaens, Dominique Franco, Sandrine Imbeaud, Francis Rousseau, Daniel Azoulay, Jean Saric, Jean–Frédéric Blanc, Charles Balabaud, Paulette Bioulac–Sage, Alexis Laurent, Pierre Laurent–Puig, Josep M. Llovet, Jessica Zucman–Rossi  Gastroenterology  Volume 145, Issue 1, Pages 176-187 (July 2013) DOI: 10.1053/j.gastro.2013.03.051 Copyright © 2013 AGA Institute Terms and Conditions

Figure 1 Flow chart of the study. FFPE, formalin-fixed paraffin-embedded. Gastroenterology 2013 145, 176-187DOI: (10.1053/j.gastro.2013.03.051) Copyright © 2013 AGA Institute Terms and Conditions

Figure 2 Prognosis analysis according to the 5-gene score in French training and validation cohorts. Disease-specific survival (A, B), early tumor recurrence-free survival. Event-free survival (C, D) and survival post recurrence (E) in the French training (n = 189) and validation (n = 125) cohorts according to the 5-gene score dichotomized in good (<0) and poor prognosis (≥0). Time-dependent area under the curve related to disease-specific survival of the 5-gene score in the validation cohort (F). AUC, area under the curve. Gastroenterology 2013 145, 176-187DOI: (10.1053/j.gastro.2013.03.051) Copyright © 2013 AGA Institute Terms and Conditions

Figure 3 Subgroup analysis using the 5-gene score. Subgroup analysis for disease-specific survival among patients classified in the poor prognostic group (5-gene score ≥0) with results expressed using hazard ratios (A). Disease-specific survival according to the 5-gene score dichotomized in good (<0) and poor prognosis (≥0) in different subgroups: HCC of less or more than 5 cm (B), single or multinodular HCC (C), presence or absence of microvascular invasion (D), Edmonson grade I−II or III−IV (E), and BCLC stage A or B (F). All the subgroups analysis were performed on the whole cohort from France (n = 314). AFP, α-fetoprotein; CLIP, cancer of the liver Italian program; HCV, hepatitis C virus; HR, hazard ratio; JIS, Japan Integrated Staging. Gastroenterology 2013 145, 176-187DOI: (10.1053/j.gastro.2013.03.051) Copyright © 2013 AGA Institute Terms and Conditions

Figure 4 Development of a composite nomogram to predict survival. The clinico-molecular nomogram integrated the 5-gene score, BCLC classification, and microvascular invasion in French cohorts. Each component gives points and the sum of the points calculated a linear predictor and a 5-year risk of tumor-related death (A). The whole population was divided in 3 subgroups according to the total number of points given by the nomogram: patients at low risk (<60 points), intermediate risk (60−120 points), and high risk (>120 points) of death (B). Gastroenterology 2013 145, 176-187DOI: (10.1053/j.gastro.2013.03.051) Copyright © 2013 AGA Institute Terms and Conditions

Figure 5 External validation of the 5-gene signature combination with molecular signature of adjacent cirrhotic nontumor tissue. Kaplan-Meier curves for overall survival in the first external validation set (HCC Genomic Consortium14) evaluating the prognostic performance of the 5-gene signature from the tumor ([A], n = 213), the poor-survival signature from the adjacent tissue ([B], patient follow-up updated from previously reported5, n = 153), and a combined prediction of both (C). Gastroenterology 2013 145, 176-187DOI: (10.1053/j.gastro.2013.03.051) Copyright © 2013 AGA Institute Terms and Conditions