Introduction: We aimed to compare the Barcelona Clinic
Liver Cancer (BCLC) and Hong Kong Liver Cancer (HKLC)
staging systems.
Materials and Methods: This is a retrospective study on
patients with newly diagnosed hepatocellular carcinoma
(HCC) at the University Malaya Medical Centre between 2011
and 2014. Survival times were analysed using the KaplanMeier procedure and comparison between groups was done
using the log rank test.
Results: The data of 190 patients was analysed. Chronic
hepatitis B was the most common aetiology for HCC (43.7%),
but a large proportion was cryptogenic or non-alcoholic
steatohepatitis-related (41.6%). Only 11.1% were diagnosed
early (BCLC Stage 0-A) while majority were diagnosed at an
intermediate stage (BCLC Stage B, 53.7%). The median
survival rate was significantly different between the different
groups when either of the staging systems was used (p<0.05
for all comparisons). However, the two staging systems
lacked agreement (weighted kappa 0.519, 95%CI: 0.449,
0.589) with significant difference in median survival rates
between BCLC Stage A and HKLC Stage 2, and between
BCLC Stage C and HKLC Stage 4.
Conclusion: Both staging systems were able to stratify
patients according to survival, but they only had moderate
agreement with significant differences observed in two
groups of the staging systems.