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Comparative study of survival of patients with hepatocellular carcinoma predicted by different staging systems using multivariate analysis.
- Source :
-
European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology [Eur J Surg Oncol] 2005 Oct; Vol. 31 (8), pp. 882-90. - Publication Year :
- 2005
-
Abstract
- Aims: In a previous pilot study, we reported the usefulness of the modified the Cancer of the Liver Italian Program (CLIP) score for patients with hepatocellular carcinoma (HCC). To determine the best staging system for predicting the survival of HCC patients, we conducted a comparative analysis of prognosis using multivariate analysis in 210 Japanese HCC patients who underwent hepatic resection.<br />Methods: We compared the survival as predicted by various staging systems, including tumour node metastasis (TNM) stage of the American Joint Commission on Cancer (AJCC) and the Liver Cancer Study Group of Japan, the Japan Integrated Staging (JIS) score (Japanese TNM and Child-Pugh classification), CLIP score and our modified CLIP score using protein induced by vitamin K absence or antagonist II (PIVKA-II).<br />Results: Univariate analysis showed that discrimination of disease-free survival in the early and advanced stages by the JIS score and modified CLIP score was clearer than by the Japanese or AJCC TNM or the original CLIP score. Discrimination between stages of overall survival by all staging systems was significant. Multivariate analysis showed that the JIS, CLIP and modified CLIP scores were better staging systems for predicting survival than the Japanese and AJCC TNM. The modified CLIP score showed the lowest Akaike information criteria statistical value for disease-free and overall survival, which means the best discrimination ability for patient survival compared with the JIS score and CLIP score.<br />Conclusions: A staging system that combines tumour factors, sensitive tumour marker(s) and hepatic function is the best predictor of prognosis of HCC patients.
- Subjects :
- Adult
Aged
Aged, 80 and over
Biomarkers analysis
Biomarkers, Tumor analysis
Carcinoma, Hepatocellular physiopathology
Carcinoma, Hepatocellular surgery
Disease-Free Survival
Female
Forecasting
Hepatectomy
Humans
Liver physiopathology
Liver Neoplasms physiopathology
Liver Neoplasms surgery
Lymphatic Metastasis pathology
Male
Middle Aged
Multivariate Analysis
Neoadjuvant Therapy
Neoplasm Recurrence, Local pathology
Neoplasm Staging statistics & numerical data
Protein Precursors analysis
Prothrombin analysis
Retrospective Studies
Survival Rate
Carcinoma, Hepatocellular pathology
Liver Neoplasms pathology
Neoplasm Staging methods
Subjects
Details
- Language :
- English
- ISSN :
- 0748-7983
- Volume :
- 31
- Issue :
- 8
- Database :
- MEDLINE
- Journal :
- European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology
- Publication Type :
- Academic Journal
- Accession number :
- 15993031
- Full Text :
- https://doi.org/10.1016/j.ejso.2005.04.016