Can More Aggressive Treatment Improve Prognosis in Patients with Hepatocellular Carcinoma? A Direct Comparison of the Hong Kong Liver Cancer and Barcelona Clinic Liver Cancer Algorithms
Gut and Liver 2018³â 12±Ç 1È£ p.94 ~ p.101
ÀÌ¿µ¼±(Lee Young-Sun) - Korea University College of Medicine Department of Internal Medicine
¼¿¬¼®(Seo Yeon-Seok) - Korea University College of Medicine Department of Internal Medicine
±èÁöÈÆ(Kim Ji-Hoon) - Korea University College of Medicine Department of Internal Medicine
ÀÌÁØ¿µ(Lee June-Young) - Korea University College of Medicine Department of Biostatistics
±èÇظ²(Kim Hae-Rim) - Korea University College of Medicine Department of Internal Medicine
À¯¾çÀç(Yoo Yang-Jae) - Korea University College of Medicine Department of Internal Medicine
±èż®(Kim Tae-Suk) - Kangwon National University School of Medicine Department of Internal Medicine
°¼ºÈñ(Kang Seong-Hee) - Korea University College of Medicine Department of Internal Medicine
¼»óÁØ(Suh Sang-June) - Korea University College of Medicine Department of Internal Medicine
ÁÖ¹®°æ(Joo Moon-Kyung) - Korea University College of Medicine Department of Internal Medicine
Á¤¿µ°É(Jung Young-Kul) - Korea University College of Medicine Department of Internal Medicine
À̹üÀç(Lee Beom-Jae) - Korea University College of Medicine Department of Internal Medicine
ÀÓÇüÁØ(Yim Hyung-Joon) - Korea University College of Medicine Department of Internal Medicine
¿¬Á¾Àº(Yeon Jong-Eun) - Korea University College of Medicine Department of Internal Medicine
±èÀç¼±(Kim Jae-Seon) - Korea University College of Medicine Department of Internal Medicine
¹ÚÁ¾Àç(Park Jong-Jae) - Korea University College of Medicine Department of Internal Medicine
¾ö¼øÈ£(Um Soon-Ho) - Korea University College of Medicine Department of Internal Medicine
¹Ú¿µÅÂ(Bak Young-Tae) - Korea University College of Medicine Department of Internal Medicine
º¯°ü¼ö(Byun Kwan-Soo) - Korea University College of Medicine Department of Internal Medicine
Abstract
Background/Aims: In addition to the globally endorsed Barcelona Clinic Liver Cancer (BCLC) staging system, other algorithms or staging systems have been developed, including the Hong Kong Liver Cancer (HKLC) staging system. This study aimed to validate the HKLC staging system relative to the BCLC staging system for predicting survival for hepatocellular carcinoma (HCC) patients in Korea.
Methods: From 2004 to 2013, 2,571 patients newly diagnosed with HCC were consecutively enrolled at three Korea University medical centers.
Results: Both staging systems differentiated survival well (p£¼0.001). However, 1-year and 3-year survival were predicted better using the HKLC system than the BCLC system (area under the receiver operating characteristic curve: 0.869 vs 0.856 for 1 year, p=0.002; 0.841 vs 0.827 for 3 years, p=0.010). In hypothetical survival curves, the HKLC system exhibited better median overall survival than the BCLC system (33.1 months vs 19.2 months). In evaluations of prognosis according to either BCLC or HKLC treatment guidelines, risk of death was reduced in the group following only HKLC guidelines compared with the group following only BCLC guidelines (hazard ratio, 0.601; 95% confidence interval, 0.443 to 0.816; p=0.001).
Conclusions: Although both staging systems predicted and discriminated HCC prognoses well, the HKLC system showed more encouraging survival benefits than the BCLC system.
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Carcinoma, hepatocellular, Barcelona Clinic Liver Cancer, Hong Kong Liver Cancer, Neoplasm staging
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Both staging systems differentiated survival well (p<0.001).