Selecting an Optimal Staging System for Hepatocellular Carcinoma: Comparison of 5 Currently Used Prognostic Models
Selecting an appropriate staging system is crucial to predict the outcome of patients with hepatocellular carcinoma (HCC). The optimal prognostic model for HCC is under intense debate. This study investigated the prognostic ability of the 5 currently used staging systems, Barcelona Clinic Liver Canc...
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| Veröffentlicht in: | Cancer 2010-06, Vol.116 (12), p.3006-3014 |
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| creator | HSU, Chia-Yang HSIA, Cheng-Yuan HUANG, Yi-Hsiang SU, Chien-Wei LIN, Han-Chieh LEE, Pui-Ching LOONG, Che-Chuan CHIANG, Jen-Huey HUO, Teh-La LEE, Shou-Dong |
| description | Selecting an appropriate staging system is crucial to predict the outcome of patients with hepatocellular carcinoma (HCC). The optimal prognostic model for HCC is under intense debate. This study investigated the prognostic ability of the 5 currently used staging systems, Barcelona Clinic Liver Cancer (BCLC), Cancer of the Liver Italian Program (CLIP), Japan Integrated Scoring (JIS) system, tumor-node-metastasis (TNM), and Tokyo score, for HCC.
Between 2002 and 2008, 1713 prospectively enrolled HCC patients were compared for their long-term survival by using the Akaike information criterion (AIC) according to the staging or scoring methods of these 5 models.
The mean and median follow-up duration was 18 and 14 months, respectively. Among all patients, the CLIP staging system had the lowest AIC value in comparison with other systems in the Cox proportional hazards model, followed by the Tokyo score, JIS score, BCLC staging system, and TNM staging system. Patients undergoing curative treatment had a significantly better survival in comparison with patients undergoing noncurative treatment (P < .001). When the predictive accuracy of the staging systems was analyzed according to treatment strategy, the CLIP staging system had the lowest AIC value and remained the best prognostic model in patients undergoing curative (801 patients) and noncurative (912 patients) treatment.
The CLIP staging system is the best long-term prognostic model for HCC in a cohort of patient with early to advanced stage of HCC. Its predictive accuracy is independent of the treatment strategy. Selecting an optimal staging system is helpful in improving the design of future clinical trials. |
| doi_str_mv | 10.1002/cncr.25044 |
| format | Article |
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Between 2002 and 2008, 1713 prospectively enrolled HCC patients were compared for their long-term survival by using the Akaike information criterion (AIC) according to the staging or scoring methods of these 5 models.
The mean and median follow-up duration was 18 and 14 months, respectively. Among all patients, the CLIP staging system had the lowest AIC value in comparison with other systems in the Cox proportional hazards model, followed by the Tokyo score, JIS score, BCLC staging system, and TNM staging system. Patients undergoing curative treatment had a significantly better survival in comparison with patients undergoing noncurative treatment (P < .001). When the predictive accuracy of the staging systems was analyzed according to treatment strategy, the CLIP staging system had the lowest AIC value and remained the best prognostic model in patients undergoing curative (801 patients) and noncurative (912 patients) treatment.
The CLIP staging system is the best long-term prognostic model for HCC in a cohort of patient with early to advanced stage of HCC. Its predictive accuracy is independent of the treatment strategy. Selecting an optimal staging system is helpful in improving the design of future clinical trials.</description><identifier>ISSN: 0008-543X</identifier><identifier>EISSN: 1097-0142</identifier><identifier>DOI: 10.1002/cncr.25044</identifier><identifier>PMID: 20564406</identifier><identifier>CODEN: CANCAR</identifier><language>eng</language><publisher>Hoboken, NJ: Wiley-Blackwell</publisher><subject>Aged ; Biological and medical sciences ; Carcinoma, Hepatocellular - mortality ; Carcinoma, Hepatocellular - pathology ; Carcinoma, Hepatocellular - therapy ; Female ; Follow-Up Studies ; Gastroenterology. Liver. Pancreas. Abdomen ; Humans ; Liver Neoplasms - mortality ; Liver Neoplasms - pathology ; Liver Neoplasms - therapy ; Liver. Biliary tract. Portal circulation. Exocrine pancreas ; Lymphatic Metastasis ; Male ; Medical sciences ; Middle Aged ; Models, Biological ; Neoplasm Staging - methods ; Prognosis ; Tumors</subject><ispartof>Cancer, 2010-06, Vol.116 (12), p.3006-3014</ispartof><rights>2015 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c190t-472aacbc40d0109b678f13cda36a6314165701e25ce4cabdd759893806e8aea3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=22885569$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/20564406$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>HSU, Chia-Yang</creatorcontrib><creatorcontrib>HSIA, Cheng-Yuan</creatorcontrib><creatorcontrib>HUANG, Yi-Hsiang</creatorcontrib><creatorcontrib>SU, Chien-Wei</creatorcontrib><creatorcontrib>LIN, Han-Chieh</creatorcontrib><creatorcontrib>LEE, Pui-Ching</creatorcontrib><creatorcontrib>LOONG, Che-Chuan</creatorcontrib><creatorcontrib>CHIANG, Jen-Huey</creatorcontrib><creatorcontrib>HUO, Teh-La</creatorcontrib><creatorcontrib>LEE, Shou-Dong</creatorcontrib><title>Selecting an Optimal Staging System for Hepatocellular Carcinoma: Comparison of 5 Currently Used Prognostic Models</title><title>Cancer</title><addtitle>Cancer</addtitle><description>Selecting an appropriate staging system is crucial to predict the outcome of patients with hepatocellular carcinoma (HCC). The optimal prognostic model for HCC is under intense debate. This study investigated the prognostic ability of the 5 currently used staging systems, Barcelona Clinic Liver Cancer (BCLC), Cancer of the Liver Italian Program (CLIP), Japan Integrated Scoring (JIS) system, tumor-node-metastasis (TNM), and Tokyo score, for HCC.
Between 2002 and 2008, 1713 prospectively enrolled HCC patients were compared for their long-term survival by using the Akaike information criterion (AIC) according to the staging or scoring methods of these 5 models.
The mean and median follow-up duration was 18 and 14 months, respectively. Among all patients, the CLIP staging system had the lowest AIC value in comparison with other systems in the Cox proportional hazards model, followed by the Tokyo score, JIS score, BCLC staging system, and TNM staging system. Patients undergoing curative treatment had a significantly better survival in comparison with patients undergoing noncurative treatment (P < .001). When the predictive accuracy of the staging systems was analyzed according to treatment strategy, the CLIP staging system had the lowest AIC value and remained the best prognostic model in patients undergoing curative (801 patients) and noncurative (912 patients) treatment.
The CLIP staging system is the best long-term prognostic model for HCC in a cohort of patient with early to advanced stage of HCC. Its predictive accuracy is independent of the treatment strategy. Selecting an optimal staging system is helpful in improving the design of future clinical trials.</description><subject>Aged</subject><subject>Biological and medical sciences</subject><subject>Carcinoma, Hepatocellular - mortality</subject><subject>Carcinoma, Hepatocellular - pathology</subject><subject>Carcinoma, Hepatocellular - therapy</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Gastroenterology. Liver. Pancreas. Abdomen</subject><subject>Humans</subject><subject>Liver Neoplasms - mortality</subject><subject>Liver Neoplasms - pathology</subject><subject>Liver Neoplasms - therapy</subject><subject>Liver. Biliary tract. Portal circulation. Exocrine pancreas</subject><subject>Lymphatic Metastasis</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Models, Biological</subject><subject>Neoplasm Staging - methods</subject><subject>Prognosis</subject><subject>Tumors</subject><issn>0008-543X</issn><issn>1097-0142</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2010</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpFkE1rFEEQhhsxmE304g-QvogQmFj9NR_eZFATSIiwEbwNtT01y0hP99jdc9h_n1mzal2KKh5eqh7G3gq4FgDyo_U2XksDWr9gGwFNVYDQ8iXbAEBdGK1-nrOLlH6tYyWNesXOJZhSayg3LG7Jkc2j33P0_GHO44SObzPuj6vtIWWa-BAiv6EZc7Dk3OIw8hajHX2Y8BNvwzRjHFPwPAzc8HaJkXx2B_4jUc-_x7D3IeXR8vvQk0uv2dmALtGbU79kj1-_PLY3xd3Dt9v2811hRQO50JVEtDuroYf1qV1Z1YNQtkdVYqmEFqWpQJA0lrTFXd9XpqkbVUNJNRKqS_bhOXaO4fdCKXfTmI73o6ewpK5SawmQciWvnkkbQ0qRhm6Oq4Z46AR0R8Pd0XD3x_AKvzvFLruJ-n_oX6Ur8P4EYLLohojejuk_J-vamLJRT0SihLU</recordid><startdate>20100615</startdate><enddate>20100615</enddate><creator>HSU, Chia-Yang</creator><creator>HSIA, Cheng-Yuan</creator><creator>HUANG, Yi-Hsiang</creator><creator>SU, Chien-Wei</creator><creator>LIN, Han-Chieh</creator><creator>LEE, Pui-Ching</creator><creator>LOONG, Che-Chuan</creator><creator>CHIANG, Jen-Huey</creator><creator>HUO, Teh-La</creator><creator>LEE, Shou-Dong</creator><general>Wiley-Blackwell</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20100615</creationdate><title>Selecting an Optimal Staging System for Hepatocellular Carcinoma: Comparison of 5 Currently Used Prognostic Models</title><author>HSU, Chia-Yang ; HSIA, Cheng-Yuan ; HUANG, Yi-Hsiang ; SU, Chien-Wei ; LIN, Han-Chieh ; LEE, Pui-Ching ; LOONG, Che-Chuan ; CHIANG, Jen-Huey ; HUO, Teh-La ; LEE, Shou-Dong</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c190t-472aacbc40d0109b678f13cda36a6314165701e25ce4cabdd759893806e8aea3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2010</creationdate><topic>Aged</topic><topic>Biological and medical sciences</topic><topic>Carcinoma, Hepatocellular - mortality</topic><topic>Carcinoma, Hepatocellular - pathology</topic><topic>Carcinoma, Hepatocellular - therapy</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Gastroenterology. Liver. Pancreas. Abdomen</topic><topic>Humans</topic><topic>Liver Neoplasms - mortality</topic><topic>Liver Neoplasms - pathology</topic><topic>Liver Neoplasms - therapy</topic><topic>Liver. Biliary tract. Portal circulation. Exocrine pancreas</topic><topic>Lymphatic Metastasis</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Models, Biological</topic><topic>Neoplasm Staging - methods</topic><topic>Prognosis</topic><topic>Tumors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>HSU, Chia-Yang</creatorcontrib><creatorcontrib>HSIA, Cheng-Yuan</creatorcontrib><creatorcontrib>HUANG, Yi-Hsiang</creatorcontrib><creatorcontrib>SU, Chien-Wei</creatorcontrib><creatorcontrib>LIN, Han-Chieh</creatorcontrib><creatorcontrib>LEE, Pui-Ching</creatorcontrib><creatorcontrib>LOONG, Che-Chuan</creatorcontrib><creatorcontrib>CHIANG, Jen-Huey</creatorcontrib><creatorcontrib>HUO, Teh-La</creatorcontrib><creatorcontrib>LEE, Shou-Dong</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Cancer</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>HSU, Chia-Yang</au><au>HSIA, Cheng-Yuan</au><au>HUANG, Yi-Hsiang</au><au>SU, Chien-Wei</au><au>LIN, Han-Chieh</au><au>LEE, Pui-Ching</au><au>LOONG, Che-Chuan</au><au>CHIANG, Jen-Huey</au><au>HUO, Teh-La</au><au>LEE, Shou-Dong</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Selecting an Optimal Staging System for Hepatocellular Carcinoma: Comparison of 5 Currently Used Prognostic Models</atitle><jtitle>Cancer</jtitle><addtitle>Cancer</addtitle><date>2010-06-15</date><risdate>2010</risdate><volume>116</volume><issue>12</issue><spage>3006</spage><epage>3014</epage><pages>3006-3014</pages><issn>0008-543X</issn><eissn>1097-0142</eissn><coden>CANCAR</coden><abstract>Selecting an appropriate staging system is crucial to predict the outcome of patients with hepatocellular carcinoma (HCC). The optimal prognostic model for HCC is under intense debate. This study investigated the prognostic ability of the 5 currently used staging systems, Barcelona Clinic Liver Cancer (BCLC), Cancer of the Liver Italian Program (CLIP), Japan Integrated Scoring (JIS) system, tumor-node-metastasis (TNM), and Tokyo score, for HCC.
Between 2002 and 2008, 1713 prospectively enrolled HCC patients were compared for their long-term survival by using the Akaike information criterion (AIC) according to the staging or scoring methods of these 5 models.
The mean and median follow-up duration was 18 and 14 months, respectively. Among all patients, the CLIP staging system had the lowest AIC value in comparison with other systems in the Cox proportional hazards model, followed by the Tokyo score, JIS score, BCLC staging system, and TNM staging system. Patients undergoing curative treatment had a significantly better survival in comparison with patients undergoing noncurative treatment (P < .001). When the predictive accuracy of the staging systems was analyzed according to treatment strategy, the CLIP staging system had the lowest AIC value and remained the best prognostic model in patients undergoing curative (801 patients) and noncurative (912 patients) treatment.
The CLIP staging system is the best long-term prognostic model for HCC in a cohort of patient with early to advanced stage of HCC. Its predictive accuracy is independent of the treatment strategy. Selecting an optimal staging system is helpful in improving the design of future clinical trials.</abstract><cop>Hoboken, NJ</cop><pub>Wiley-Blackwell</pub><pmid>20564406</pmid><doi>10.1002/cncr.25044</doi><tpages>9</tpages></addata></record> |
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| subjects | Aged Biological and medical sciences Carcinoma, Hepatocellular - mortality Carcinoma, Hepatocellular - pathology Carcinoma, Hepatocellular - therapy Female Follow-Up Studies Gastroenterology. Liver. Pancreas. Abdomen Humans Liver Neoplasms - mortality Liver Neoplasms - pathology Liver Neoplasms - therapy Liver. Biliary tract. Portal circulation. Exocrine pancreas Lymphatic Metastasis Male Medical sciences Middle Aged Models, Biological Neoplasm Staging - methods Prognosis Tumors |
| title | Selecting an Optimal Staging System for Hepatocellular Carcinoma: Comparison of 5 Currently Used Prognostic Models |
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