Barcelona Clinic Liver Cancer staging system and survival of untreated hepatocellular carcinoma in a hepatitis B virus endemic area.

Lee, Jeong-Hoon; Kim, Hwi Young; Kim, Yoon Jun; Yoon, Jung-Hwan; Chung, Jin Wook; Lee, Hyo-Suk
Journal of gastroenterology and hepatology
2015Apr ; 30 ( 4 ) :696-705.
저자 상세정보
Lee, Jeong-Hoon -
Kim, Hwi Young -
Kim, Yoon Jun -
Yoon, Jung-Hwan -
Chung, Jin Wook -
Lee, Hyo-Suk -
BACKGROUND AND AIM: A uniform staging system for hepatocellular carcinoma (HCC) is needed. In this study, the discrimination abilities of HCC staging systems (American Joint Committee on Cancer [AJCC], Barcelona Clinic Liver Cancer [BCLC], Cancer of the Liver Italian Program, and Okuda stage) were compared during the course of untreated HCC.

METHODS: We included consecutive 80 patients diagnosed with HCC, but were not treated for HCC, at a single medical center in Korea. In addition, 177 treated patients matched by prognostic factors were included to evaluate the survival gain owing to locoregional treatment.

RESULTS: The mean age of untreated patients was 58.7 years. During the observation period (median?=?41.1 months), 72 patients died (median survival?=?2.1 months; range?=?1.6-33.7 months). Among various staging systems, the BCLC system had the best discrimination ability (linear trend ?2 ?=?16.35). Multivariate analysis indicated that the intrahepatic tumor classification (AJCC T classification) was an independent predictor of overall survival (OS) (P?=?0.001). However, either node or metastasis classification failed to affect the OS significantly (both P?>?0.05). Patients undergoing intrahepatic tumor control with locoregional therapy showed prolonged survival in those patients with nodal involvement (hazard ratio?=?0.315; P?=?0.004) and extrahepatic metastasis (hazard ratio?=?0.658; P?=?0.258), respectively, after adjustment for independent prognostic factors. Compared with untreated patients, BCLC stage A and B patients had >?1 year of survival gain but those with stage C and D did not, owing to locoregional therapy. CONCLUSION: The BCLC system had the best discrimination among untreated HCC patients. However, re-evaluation of the clinical importance of nodal and metastasis classification might be required. CI - ??2014 Journal of Gastroenterology and Hepatology Foundation and Wiley Publishing Asia Pty Ltd.
hepatocellular carcinoma; natural history; overall survival; staging system
Adolescent, Adult, Carcinoma, Hepatocellular/mortality/*pathology/therapy, Child, *Endemic Diseases, Female, Hepatitis B/*epidemiology, Humans, Korea/epidemiology, Liver Neoplasms/mortality/*pathology/therapy, Male, Middle Aged, Multivariate Analysis, Neoplasm Staging/*methods, Predictive Value of Tests, Prognosis, Survival Rate, Young Adult

주제명(Target field)
연구참여(Sample size)
질병특성(Condition Category)
연구설계(Study Design)
중재방법(Intervention Type)
중재명칭(Intervention Name)
The BCLC system had the best discrimination among untreated HCC patients
연구비지원(Fund Source)
근거수준평가(Evidence Hierarchy)
ICD 03