Prognosis of hepatocellular carcinoma: comparison of 7 staging systems in an American cohort - PubMed (original) (raw)
Comparative Study
doi: 10.1002/hep.20636.
Affiliations
- PMID: 15795889
- DOI: 10.1002/hep.20636
Free article
Comparative Study
Prognosis of hepatocellular carcinoma: comparison of 7 staging systems in an American cohort
Jorge A Marrero et al. Hepatology. 2005 Apr.
Free article
Abstract
Currently there is no consensus as to which staging system is best in predicting the survival of patients with hepatocellular carcinoma (HCC). The aims of this study were to identify independent predictors of survival and to compare 7 available prognostic staging systems in patients with HCC. A total of 239 consecutive patients with cirrhosis and HCC seen between January 1, 2000, and December 31, 2003, were included. Demographic, laboratory, and tumor characteristics and performance status were determined at diagnosis and before therapy. Predictors of survival were identified using the Kaplan-Meir test and the Cox model. Sixty-two percent of patients had hepatitis C, 56% had more than 1 tumor nodule, 24% had portal vein thrombosis, and 29% did not receive any cancer treatment. At the time of censorship, 153 (63%) patients had died. The 1- and 3-year survival of the entire cohort was 58% and 29%, respectively. The independent predictors of survival were performance status (P < .0001), MELD score greater than 10 (P = .001), portal vein thrombosis (P = .0001), and tumor diameter greater than 4 cm (P = .001). Treatment of HCC was related to overall survival. The Barcelona Clinic Liver Cancer (BCLC) staging system had the best independent predictive power for survival when compared with the other 6 prognostic systems. In conclusion, performance status, tumor extent, liver function, and treatment were independent predictors of survival mostly in patients with cirrhosis and HCC. The BCLC staging system includes aspects of all of these elements and provided the best prognostic stratification for our cohort of patients with HCC.
Comment in
- Comparison of staging systems for HCC: one more positive answer or mission impossible?
Huo TI, Wu JC, Lee SD. Huo TI, et al. Hepatology. 2005 Jul;42(1):238-9. doi: 10.1002/hep.20758. Hepatology. 2005. PMID: 15962309 No abstract available. - Staging of hepatocellular carcinoma.
Pawlik TM, Abdalla EK, Thomas M, Roh MS, Lauwers GY, Ribero D, Poon RT, Belghiti J, Nagorney DM, Vauthey JN. Pawlik TM, et al. Hepatology. 2005 Sep;42(3):738-9; author reply 739-40. doi: 10.1002/hep.20849. Hepatology. 2005. PMID: 16116639 No abstract available.
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