Can More Aggressive Treatment Improve Prognosis in Patients with Hepatocellular Carcinoma? A Direct Comparison of the Hong Kong Liver Cancer and Barcelona Clinic Liver Cancer Algorithms
- Author:
Young Sun LEE
1
;
Yeon Seok SEO
;
Ji Hoon KIM
;
Juneyoung LEE
;
Hae Rim KIM
;
Yang Jae YOO
;
Tae Suk KIM
;
Seong Hee KANG
;
Sang Jun SUH
;
Moon Kyung JOO
;
Young Kul JUNG
;
Beom Jae LEE
;
Hyung Joon YIM
;
Jong Eun YEON
;
Jae Seon KIM
;
Jong Jae PARK
;
Soon Ho UM
;
Young Tae BAK
;
Kwan Soo BYUN
Author Information
- Publication Type:Original Article
- Keywords: Carcinoma; hepatocellular; Barcelona Clinic Liver Cancer; Hong Kong Liver Cancer; Neoplasm staging
- MeSH: Academic Medical Centers; Carcinoma, Hepatocellular; Hong Kong; Humans; Korea; Liver Neoplasms; Liver; Neoplasm Staging; Prognosis; ROC Curve
- From:Gut and Liver 2018;12(1):94-101
- CountryRepublic of Korea
- Language:English
- Abstract: BACKGROUND/AIMS: In addition to the globally endorsed Barcelona Clinic Liver Cancer (BCLC) staging system, other algorithms or staging systems have been developed, including the Hong Kong Liver Cancer (HKLC) staging system. This study aimed to validate the HKLC staging system relative to the BCLC staging system for predicting survival for hepatocellular carcinoma (HCC) patients in Korea. METHODS: From 2004 to 2013, 2,571 patients newly diagnosed with HCC were consecutively enrolled at three Korea University medical centers. RESULTS: Both staging systems differentiated survival well (p < 0.001). However, 1-year and 3-year survival were predicted better using the HKLC system than the BCLC system (area under the receiver operating characteristic curve: 0.869 vs 0.856 for 1 year, p=0.002; 0.841 vs 0.827 for 3 years, p=0.010). In hypothetical survival curves, the HKLC system exhibited better median overall survival than the BCLC system (33.1 months vs 19.2 months). In evaluations of prognosis according to either BCLC or HKLC treatment guidelines, risk of death was reduced in the group following only HKLC guidelines compared with the group following only BCLC guidelines (hazard ratio, 0.601; 95% confidence interval, 0.443 to 0.816; p=0.001). CONCLUSIONS: Although both staging systems predicted and discriminated HCC prognoses well, the HKLC system showed more encouraging survival benefits than the BCLC system.
