• 作者：Mario Ferná ; ndez-Ruiz^a ; ^{mario_fdezruiz@yahoo.es} ; Juan Manuel Guerra-Vales^a ; Juan Vila-Santos^a ; Francisco Colina-Ruizdelgado^b
• 关键词：Carcinoma hepatocelular ; Historia natural ; Sistema de estadificaci&oacute ; n ; Pron&oacute ; stico ; Okuda ; Cancer of the Liver Italian Program ; Barcelona Clinic Liver Cancer ; Japan Integrated Staging
• 刊名：Medicina Cl铆nica
• 出版年：2009
• 期刊代码：pca254_00257753
• 类别：med
• 出版时间：24 October 2009
• 卷：133
• 期：15
• 页码：581-585
• 文件大小：168 K

Background and objective

Patients with hepatocellular carcinoma (HCC) not amenable to locoregional therapy have some specific clinical characteristics (advanced cirrhosis or extrahepatic spread) that lead us to ascertain the prognostic efficacy of the different staging systems proposed for this entity.

Patients and method

We analyze 100 patients (69 males) with a mean age of 70.2 (10.7) years. Tumor staging was performed at baseline according to the following systems: Okuda, Cancer of the Liver Italian Program (CLIP), Barcelona Clinic Liver Cancer (BCLC), and Japan Integrated Staging (JIS) score. We determine the area under the receiver operating characteristic curve (AUC) using the 6 and 12-month mortality as endpoint.

Results

The BCLC system had the best predictive power for mortality both at 6 (AUC, 0.871) and 12 months (AUC, 0.924) from diagnosis. In the Cox multivariate analysis, this model showed an independent prognostic effect [hazard ratio: 9.14 for BCLC stage C versus A (p<0.001), and 9.53 for stage D versus A (p=0.004)].

Conclusions

The BCLC system provided the best prognostic stratification for patients with HCC not amenable to locoregional therapy.