Prognosis of advanced hepatocellular carcinoma patients enrolled in clinical trials can be classified by current staging systems
Journal
British Journal of Cancer
Journal Volume
107
Journal Issue
10
Pages
1672-1677
Date Issued
2012
Abstract
Background:Patients enrolled in clinical trials of advanced hepatocellular carcinoma (HCC) are usually required to have good liver reserve and organ function. However, their outcomes are still highly variable. We aimed to examine whether current staging systems can predict the survival of these highly selected patients.Methods:Patients from clinical trials involving first-line anti-Angiogenic therapy were assigned to different stage groups using the American Joint Committee on Cancer (AJCC), Barcelona Clinic Liver Cancer (BCLC), China integrated score, Cancer of the Liver Italian Program (CLIP) score, Chinese University Prognostic Index (CUPI), Groupe dEtude et de Traitement du Carcinome Hepatocellulaire (GETCH), Japan Integrated Staging (JIS) score, Okuda, Tokyo score, and a new staging system recently proposed. Survival prediction by the 10 systems was then compared by both univariate and multivariate analyses.Results:A total of 157 patients were selected for this study. In univariate analysis, all staging systems can predict patient survival except AJCC, BCLC, and JIS score. Concordance indexes for CLIP score, CUPI, and GETCH (0.752, 0.775, and 0.791, respectively) were significantly higher than those obtained for other staging systems. In multivariate analysis, the CLIP score and CUPI (P0.001 and 0.009, respectively) predicted survival more accurately than did the other tested staging systems. Hepatitis B infection and poor performance status were also associated with poor survival.Conclusion:Several HCC staging systems, especially the CLIP score and CUPI, can predict prognosis of patients who are enrolled in clinical trials of advanced HCC. ? 2012 Cancer Research UK. All rights reserved.
SDGs
Other Subjects
accuracy; adult; advanced cancer; aged; american joint committee on cancer score; article; barcelona clinic liver cancer score; cancer of the liver italian program score; cancer staging; cancer survival; china integrated score; chinese university prognostic index score; female; groupe d etude et de traitement du carcinome hepatocellulaire score; human; intermethod comparison; japan integrated staging score; liver cell carcinoma; major clinical study; male; okuda score; prediction; priority journal; prognosis; tokyo score; tournoux facon score; Adult; Aged; Aged, 80 and over; Carcinoma, Hepatocellular; Clinical Trials as Topic; Female; Humans; Liver Neoplasms; Male; Middle Aged; Multivariate Analysis; Neoplasm Staging; Predictive Value of Tests; Prognosis; Young Adult
Type
journal article