Abstract
BackgroundSeveral staging systems have been developed to evaluate patients with hepatocellular carcinoma (HCC), including the China Staging System (CS), the American Joint Committee on Cancer (AJCC) tumor-node-metastasis (TNM) staging system, and seventh edition; the Barcelona Clinic Liver Cancer (BCLC) staging system, and Cancer of the Liver Italian Program (CLIP) staging system. The optimal staging system for to evaluate patients in China with HCC has not been determined. This study was designed to determine the optimal staging system for predicting patient prognosis by comparing the performances of these four staging systems in a cohort of Chinese patients with HCC.MethodsThis study enrolled 307 consecutive Chinese patients with HCC in Shandong Province. The performances of the CS, TNM, BCLC, and CLIP staging systems were compared and ranked using a concordance index. Predictors of survival were identified using univariate and multivariate Cox model analyses.ResultsThe mean overall survival of the patient cohort was 12.08 ± 11.87 months. Independent predictors of survival included tumor size, number of lesions, tumor thromboses, cirrhosis, serum albumin level and serum total bilirubin level. Compared with the other three staging systems, the CS staging system showed optimal performance as an independent predictor of patient survival. The BCLC staging system showed the poorest performance; its treatment algorithm was not suitable for patients in this study.ConclusionsCS was the most suitable staging system for predicting survival of patients with HCC in China.Electronic supplementary materialThe online version of this article (doi:10.1186/s12885-016-2420-0) contains supplementary material, which is available to authorized users.
Highlights
Several staging systems have been developed to evaluate patients with hepatocellular carcinoma (HCC), including the China Staging System (CS), the American Joint Committee on Cancer (AJCC) tumor-node-metastasis (TNM) staging system, and seventh edition; the Barcelona Clinic Liver Cancer (BCLC) staging system, and Cancer of the Liver Italian Program (CLIP) staging system
The tumor staging system optimal for evaluating patients with HCC in Shandong province has not been determined. This retrospective study compared the performances of four staging systems, the CLIP, BCLC, AJCC TNM 7th edition, and CS staging systems, in patients with HCC in Shandong Province, China, who were treated at Qilu Hospital of Shandong University
We founded that serum total bilirubin concentration, serum albumin level and greater tumor extent were related to poor prognosis variables, indicating that the long-term survival of patients with HCC was associated with the tumor but with liver function [3, 14,15,16]
Summary
Several staging systems have been developed to evaluate patients with hepatocellular carcinoma (HCC), including the China Staging System (CS), the American Joint Committee on Cancer (AJCC) tumor-node-metastasis (TNM) staging system, and seventh edition; the Barcelona Clinic Liver Cancer (BCLC) staging system, and Cancer of the Liver Italian Program (CLIP) staging system. The tumor staging system optimal for evaluating patients with HCC in Shandong province has not been determined. This retrospective study compared the performances of four staging systems, the CLIP, BCLC, AJCC TNM 7th edition, and CS staging systems, in patients with HCC in Shandong Province, China, who were treated at Qilu Hospital of Shandong University.
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