• The graphical chart tool predicts up to about 70 per cent accuracy in liver recurrence at 3 and 5 years post-surgery
  • Establishes the foundation to better surveillance and treatment for liver cancer patients

    Singapore, 14 July 2015 – A team of doctors at National Cancer Centre Singapore (NCCS) and Singapore General Hospital (SGH) has developed a new clinical tool, the Singapore Liver Cancer Recurrence (SLICER) Score, to predict individualised cancer relapse for liver cancer patients who have undergone surgery.

    The SLICER Score calculates risk of relapse as its primary outcome measurement and is able to predict liver cancer recurrence at 3 and 5 years post-surgery. In patients undergoing surgery, the tool out-performs other conventional methods of assessing liver cancer prognosis developed by other groups.

    The SLICER Score was developed through analysing 405 patients who underwent first-line liver resection surgery between 1992 and 2007. Doctors identified distinctive variables such as tumour characteristics and the possible effect of field change (i.e. liver cirrhosis) which accounts for both early and late recurrences of liver cancer.

    Dr Tan Min Han, lead author and visiting consultant at NCCS explains the significant development, "From a clinical perspective, there is a need for an accurate model of predicting individualised probabilities of cancer recurrence after liver surgery. This would guide patient counselling and effective scheduling of clinical surveillance, which is important as early detection of recurrence could be amenable to further curative surgical resection."

    The fourth most common male cancer in Singapore, liver cancer is often associated with a poor prognosis and is responsible for a disproportionately high global burden of morbidity and mortality, particularly in Asia.

    A/Prof Cheow Peng Chung, Senior Consultant, Department of Hepatopancreatobiliary and Transplant Surgery, SGH and co-author of the study commented, "Surgery is the most important approach to cure patients with localised liver cancer. We want to share SGH's experience with the SLICER so that it can be a guide for the rest of the world to predict outcomes from this challenging operation. Moving forward, the SLICER could be paired with a better surveillance model to determine if high-risk patients truly benefit from closer surveillance."

    To date, there are no randomised trials of surveillance strategies in post-operative liver cancer to determine the benefit of risk-adjusted strategies. SLICER could serve as an appropriate prognostic model for such trials, and provide a foundation for individualised patient counselling and management, biomarker development, and trial design for adjuvant trials for liver cancer patients.

    The SLICER score nomogram has been set up by Dr Tan Min Han at www.slicerscore.com. The nomogram was devised for use strictly by medically qualified staff only.