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KMID : 1188320180120010094
Gut and Liver
2018 Volume.12 No. 1 p.94 ~ p.101
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
Lee Young-Sun

Seo Yeon-Seok
Kim Ji-Hoon
Lee June-Young
Kim Hae-Rim
Yoo Yang-Jae
Kim Tae-Suk
Kang Seong-Hee
Suh Sang-June
Joo Moon-Kyung
Jung Young-Kul
Lee Beom-Jae
Yim Hyung-Joon
Yeon Jong-Eun
Kim Jae-Seon
Park Jong-Jae
Um Soon-Ho
Bak Young-Tae
Byun Kwan-Soo
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£¼0.001). 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.
KEYWORD
Carcinoma, hepatocellular, Barcelona Clinic Liver Cancer, Hong Kong Liver Cancer, Neoplasm staging
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SCI(E) MEDLINE ÇмúÁøÈïÀç´Ü(KCI) KoreaMed