BACKGROUND: The aim of this study was to compare the ability of staging systems (American Joint Committee on Cancer/Union Internationale contre le Cancer [AJCC/UICC], Japanese TNM, Pittsburgh, United Network for Organ Sharing [UNOS], Cancer of the Liver Italian Program [CLIP], Japan Integrated Staging [JIS], and Barcelona Clinic Liver Cancer [BCLC]) to predict survival after liver transplantation for hepatocellular carcinoma. STUDY DESIGN: Four hundred ninety consecutive patients who underwent liver transplantation for hepatocellular carcinoma at 4 centers (1985 to 2005) were identified using a registry (US, Belgium, Germany). End points were overall (OS) and recurrence-free survival (RFS). Survival by stage was compared with the log-rank test. Sequential stage-wise discrimination of each system was evaluated using Cox regression. RESULTS: Three- and 5-year overall survival rates were 71% and 64%, respectively; recurrence-free survival rates were 67% and 61%, respectively. Median followup among 327 living and 308 recurrence-free patients was 40 months. In only three systems--AJCC/UICC, Japanese TNM, and Pittsburgh--were overall and recurrence-free survivals longer for patients with low stage versus more advanced stage. For overall and recurrence-free survivals, sequential stages were different only for AJCC/UICC. In the Japanese TNM system, stages II and I were similar; for Pittsburgh, grades 3 and 2 were similar. For the United Network for Organ Sharing system, stages II and I and stages IVA1 and III were similar. All stages were similar for the Cancer of the Liver Italian Program. For the Japan Integrated Staging, scores 2 and 1 and scores 4 and 3 were similar. In the Barcelona Clinic Liver Cancer, stage D patients had significantly better survival than patients at stage C. CONCLUSIONS: The AJCC/UICC staging system provides the best stratification of prognosis for patients undergoing liver transplantation for hepatocellular carcinoma. This confirms previous analyses in patients treated with hepatic resection. The AJCC/UICC staging system should be considered for uniform prediction of outcomes after surgery for hepatocellular carcinoma.
BACKGROUND: The aim of this study was to compare the ability of staging systems (American Joint Committee on Cancer/Union Internationale contre le Cancer [AJCC/UICC], Japanese TNM, Pittsburgh, United Network for Organ Sharing [UNOS], Cancer of the Liver Italian Program [CLIP], Japan Integrated Staging [JIS], and Barcelona Clinic Liver Cancer [BCLC]) to predict survival after liver transplantation for hepatocellular carcinoma. STUDY DESIGN: Four hundred ninety consecutive patients who underwent liver transplantation for hepatocellular carcinoma at 4 centers (1985 to 2005) were identified using a registry (US, Belgium, Germany). End points were overall (OS) and recurrence-free survival (RFS). Survival by stage was compared with the log-rank test. Sequential stage-wise discrimination of each system was evaluated using Cox regression. RESULTS: Three- and 5-year overall survival rates were 71% and 64%, respectively; recurrence-free survival rates were 67% and 61%, respectively. Median followup among 327 living and 308 recurrence-free patients was 40 months. In only three systems--AJCC/UICC, Japanese TNM, and Pittsburgh--were overall and recurrence-free survivals longer for patients with low stage versus more advanced stage. For overall and recurrence-free survivals, sequential stages were different only for AJCC/UICC. In the Japanese TNM system, stages II and I were similar; for Pittsburgh, grades 3 and 2 were similar. For the United Network for Organ Sharing system, stages II and I and stages IVA1 and III were similar. All stages were similar for the Cancer of the Liver Italian Program. For the Japan Integrated Staging, scores 2 and 1 and scores 4 and 3 were similar. In the Barcelona Clinic Liver Cancer, stage D patients had significantly better survival than patients at stage C. CONCLUSIONS: The AJCC/UICC staging system provides the best stratification of prognosis for patients undergoing liver transplantation for hepatocellular carcinoma. This confirms previous analyses in patients treated with hepatic resection. The AJCC/UICC staging system should be considered for uniform prediction of outcomes after surgery for hepatocellular carcinoma.
Authors: Al B Benson; Thomas A Abrams; Edgar Ben-Josef; P Mark Bloomston; Jean F Botha; Bryan M Clary; Anne Covey; Steven A Curley; Michael I D'Angelica; Rene Davila; William D Ensminger; John F Gibbs; Daniel Laheru; Mokenge P Malafa; Jorge Marrero; Steven G Meranze; Sean J Mulvihill; James O Park; James A Posey; Jasgit Sachdev; Riad Salem; Elin R Sigurdson; Constantinos Sofocleous; Jean-Nicolas Vauthey; Alan P Venook; Laura Williams Goff; Yun Yen; Andrew X Zhu Journal: J Natl Compr Canc Netw Date: 2009-04 Impact factor: 11.908
Authors: Jean-Nicolas Vauthey; Elijah Dixon; Eddie K Abdalla; W Scott Helton; Timothy M Pawlik; Bachir Taouli; Antoine Brouquet; Reid B Adams Journal: HPB (Oxford) Date: 2010-06 Impact factor: 3.647
Authors: Riad Salem; Robert J Lewandowski; Vanessa L Gates; Charles W Nutting; Ravi Murthy; Steven C Rose; Michael C Soulen; Jean-Francois H Geschwind; Laura Kulik; Yun Hwan Kim; Carlo Spreafico; Marco Maccauro; Lourens Bester; Daniel B Brown; Robert K W Ryu; Daniel Y Sze; William S Rilling; Kent T Sato; Bruno Sangro; Jose Ignacio Bilbao; Tobias F Jakobs; Samer Ezziddin; Suyash Kulkarni; Aniruddha Kulkarni; David M Liu; David Valenti; Philip Hilgard; Gerald Antoch; Stefan P Muller; Hamad Alsuhaibani; Mary F Mulcahy; Marta Burrel; Maria Isabel Real; Stewart Spies; Abdulredha A Esmail; Jean-Luc Raoul; Etienne Garin; Mathew S Johnson; Al B Benson; Ricky A Sharma; Harpreet Wasan; Bieke Lambert; Khairuddin Memon; Andrew S Kennedy; Ahsun Riaz Journal: J Vasc Interv Radiol Date: 2011-03 Impact factor: 3.464
Authors: Hari Nathan; Gilles Mentha; Hugo P Marques; Lorenzo Capussotti; Pietro Majno; Luca Aldrighetti; Carlo Pulitano; Laura Rubbia-Brandt; Nadia Russolillo; Benjamin Philosophe; Eduardo Barroso; Alessandro Ferrero; Richard D Schulick; Michael A Choti; Timothy M Pawlik Journal: HPB (Oxford) Date: 2009-08 Impact factor: 3.647