Currently there is no consensus as to which staging system is best in predicting the survival of patients with hepatocellular carcinoma.
Dr Marrero and colleagues from Michigan conducted a study to identify independent predictors of survival and to compare 7 available prognostic staging systems in patients with hepatocellular carcinoma.
The investigators included a total of 239 consecutive patients with cirrhosis and hepatocellular carcinoma between 2000 and 2003.
The team determined demographic, laboratory, and tumor characteristics and performance status at diagnosis and before therapy.
Predictors of survival were identified using the Kaplan-Meir test and the Cox model.
|The Barcelona Clinic Liver Cancer staging system had the best independent predictive power for survival|
The investigators reported that 62% of patients had hepatitis C, 56% had more than 1 tumor nodule, 24% had portal vein thrombosis, and 29% did not receive any cancer treatment.
The researchers also noted that at the time of censorship, 63% patients had died and the 1 and 3 year survival of the entire cohort was 58% and 29%, respectively.
The independent predictors of survival were performance status, Model End Stage Liver Disease score greater than 10, portal vein thrombosis, and tumor diameter greater than 4 cm.
The research team showed that treatment of hepatocellular carcinoma was related to overall survival.
Furthermore, the researchers found that the Barcelona Clinic Liver Cancer staging system had the best independent predictive power for survival when compared with the other 6 prognostic systems.
Dr concluded, “Performance status, tumor extent, liver function, and treatment were independent predictors of survival mostly in patients with cirrhosis and hepatocellular carcinoma.”
“The Barcelona Clinic Liver Cancer staging system includes aspects of all of these elements and provided the best prognostic stratification for our cohort of patients with hepatocellular carcinoma.”