Kwang Min Kim1, Dong Hyun Sinn2, Sin-Ho Jung3, Geum-Youn Gwak2, Yong-Han Paik2, Moon Seok Choi2, Joon Hyeok Lee2, Kwang Cheol Koh2, Seung Woon Paik4. 1. Department of Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, South Korea. 2. Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea. 3. Biostatistics and Clinical Epidemiology Center, Samsung Medical Center, Seoul, South Korea. 4. Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea. sw.paik@samsung.com.
Abstract
BACKGROUND & AIMS: Several staging systems have been proposed for hepatocellular carcinoma (HCC). Among them, only the Barcelona Clinic Liver Cancer (BCLC) and Hong Kong Liver Cancer (HKLC) staging systems also recommend treatment modality. This study was designed to see whether BCLC and HKLC staging can guide treatment strategy, so analyzed whether patients survival is better for those who received recommended therapy by each staging system. METHODS: A total of 3515 treatment-naïve, newly diagnosed HCC patients at a single centre were analyzed. RESULTS: Five-year survival rates according to BCLC stages: 0 = 79.1%, A = 62.9%, B = 40.3%, C = 21.3% and D = 27.0%; 5-year survival rates according to HKLC stages: I = 72.3%, IIa = 54.9%, IIb = 50.6%, IIIa = 21.3%, IIIb = 10.2%, IVa = 16.7%, IVb = 7.2%, Va = 47.1% and Vb = 11.3%. The C-indices of the BCLC and HKLC staging systems were 0.708 and 0.732 respectively. Patient survival was better when patients received the recommended treatment in stages 0 or A; survival was worse if treatment began at stage B, C or D. For HKLC staging system, survival was better when patients received the recommended treatment in stages I, IIa, IIb, IIIa or Va but was worse when treatment began in stages IIIb, IVa, IVb or Vb. CONCLUSION: Both the BCLC and HKLC staging systems effectively stratified patient prognosis, but neither could direct therapy for a large proportion of patients; for some stages, recommended therapy was associated with worse prognosis.
BACKGROUND & AIMS: Several staging systems have been proposed for hepatocellular carcinoma (HCC). Among them, only the Barcelona Clinic Liver Cancer (BCLC) and Hong Kong Liver Cancer (HKLC) staging systems also recommend treatment modality. This study was designed to see whether BCLC and HKLC staging can guide treatment strategy, so analyzed whether patients survival is better for those who received recommended therapy by each staging system. METHODS: A total of 3515 treatment-naïve, newly diagnosed HCCpatients at a single centre were analyzed. RESULTS: Five-year survival rates according to BCLC stages: 0 = 79.1%, A = 62.9%, B = 40.3%, C = 21.3% and D = 27.0%; 5-year survival rates according to HKLC stages: I = 72.3%, IIa = 54.9%, IIb = 50.6%, IIIa = 21.3%, IIIb = 10.2%, IVa = 16.7%, IVb = 7.2%, Va = 47.1% and Vb = 11.3%. The C-indices of the BCLC and HKLC staging systems were 0.708 and 0.732 respectively. Patient survival was better when patients received the recommended treatment in stages 0 or A; survival was worse if treatment began at stage B, C or D. For HKLC staging system, survival was better when patients received the recommended treatment in stages I, IIa, IIb, IIIa or Va but was worse when treatment began in stages IIIb, IVa, IVb or Vb. CONCLUSION: Both the BCLC and HKLC staging systems effectively stratified patient prognosis, but neither could direct therapy for a large proportion of patients; for some stages, recommended therapy was associated with worse prognosis.
Authors: Michael C Wallace; Matthew Knuiman; Yi Huang; George Garas; Leon A Adams; Gerry MacQuillan; David B Preen; Gary P Jeffrey Journal: Dig Dis Sci Date: 2018-05-28 Impact factor: 3.199
Authors: Michael C Wallace; Yi Huang; David B Preen; George Garas; Leon A Adams; Gerry MacQuillan; Jonathan Tibballs; John Ferguson; Shaun Samuelson; Gary P Jeffrey Journal: Dig Dis Sci Date: 2017-05-25 Impact factor: 3.199