OBJECTIVE: Hepatocellular carcinoma (HCC) staging systems were developed using data predominantly from patients who had hepatitis and cirrhosis. Given the recent change in prevalence of viral hepatitis and cirrhosis at oncology centers, which has altered the natural history of HCC, we aimed at comparing the accuracy of HCC staging systems in patients with or without hepatitis and cirrhosis. METHODS: A total of 438 patients were enrolled. Baseline clinicopathologic parameters, Barcelona Clinic Liver Cancer stage, Cancer of the Liver Italian Program score, TNM (6th edition) stage, Okuda stage, and Chinese University Prognostic Index score were prospectively obtained for all patients, and retrospectively analyzed. Kaplan-Meier analysis was used to determine overall survival (OS), Cox regression analyses were performed, and Harrell's Correspondence Index compared the staging systems' ability to predict OS duration. Subgroup analyses of patients with or without hepatitis or cirrhosis were performed. RESULTS: Median patient OS was 13.9 months; 165 patients (37.7%) had no cirrhosis and 256 patients (58.4%) had no hepatitis. Overall, all staging systems were significantly less predictive of OS in patients who did not have cirrhosis or hepatitis. CONCLUSION: Our results advocate the need to further stratify HCC based on cirrhosis and hepatitis status, which may change patient risk-stratification and, ultimately, treatment decisions.
OBJECTIVE:Hepatocellular carcinoma (HCC) staging systems were developed using data predominantly from patients who had hepatitis and cirrhosis. Given the recent change in prevalence of viral hepatitis and cirrhosis at oncology centers, which has altered the natural history of HCC, we aimed at comparing the accuracy of HCC staging systems in patients with or without hepatitis and cirrhosis. METHODS: A total of 438 patients were enrolled. Baseline clinicopathologic parameters, Barcelona Clinic Liver Cancer stage, Cancer of the Liver Italian Program score, TNM (6th edition) stage, Okuda stage, and Chinese University Prognostic Index score were prospectively obtained for all patients, and retrospectively analyzed. Kaplan-Meier analysis was used to determine overall survival (OS), Cox regression analyses were performed, and Harrell's Correspondence Index compared the staging systems' ability to predict OS duration. Subgroup analyses of patients with or without hepatitis or cirrhosis were performed. RESULTS: Median patientOS was 13.9 months; 165 patients (37.7%) had no cirrhosis and 256 patients (58.4%) had no hepatitis. Overall, all staging systems were significantly less predictive of OS in patients who did not have cirrhosis or hepatitis. CONCLUSION: Our results advocate the need to further stratify HCC based on cirrhosis and hepatitis status, which may change patient risk-stratification and, ultimately, treatment decisions.
Authors: Jordi Bruix; Jean-Luc Raoul; Morris Sherman; Vincenzo Mazzaferro; Luigi Bolondi; Antonio Craxi; Peter R Galle; Armando Santoro; Michel Beaugrand; Angelo Sangiovanni; Camillo Porta; Guido Gerken; Jorge A Marrero; Andrea Nadel; Michael Shan; Marius Moscovici; Dimitris Voliotis; Josep M Llovet Journal: J Hepatol Date: 2012-06-19 Impact factor: 25.083
Authors: Ahmed O Kaseb; Jeffrey S Morris; Manal M Hassan; Adnan M Siddiqui; E Lin; Lianchun Xiao; Eddie K Abdalla; Jean-Nicolas Vauthey; Thomas A Aloia; Sunil Krishnan; James L Abbruzzese Journal: J Clin Oncol Date: 2011-09-12 Impact factor: 44.544
Authors: Ahsun Riaz; Frank H Miller; Laura M Kulik; Paul Nikolaidis; Vahid Yaghmai; Robert J Lewandowski; Mary F Mulcahy; Robert K Ryu; Kent T Sato; Ramona Gupta; Ed Wang; Talia Baker; Michael Abecassis; Al B Benson; Albert A Nemcek; Reed Omary; Riad Salem Journal: JAMA Date: 2010-03-17 Impact factor: 56.272
Authors: S Collette; F Bonnetain; X Paoletti; M Doffoel; O Bouché; J L Raoul; P Rougier; F Masskouri; L Bedenne; J C Barbare Journal: Ann Oncol Date: 2008-02-25 Impact factor: 32.976
Authors: Josep M Llovet; Sergio Ricci; Vincenzo Mazzaferro; Philip Hilgard; Edward Gane; Jean-Frédéric Blanc; Andre Cosme de Oliveira; Armando Santoro; Jean-Luc Raoul; Alejandro Forner; Myron Schwartz; Camillo Porta; Stefan Zeuzem; Luigi Bolondi; Tim F Greten; Peter R Galle; Jean-François Seitz; Ivan Borbath; Dieter Häussinger; Tom Giannaris; Minghua Shan; Marius Moscovici; Dimitris Voliotis; Jordi Bruix Journal: N Engl J Med Date: 2008-07-24 Impact factor: 91.245