Previously proposed staging systems for hepatocellular carcinoma involve clinical, imaging, or pathologic factors in the evaluation.
Dr Hidenori Toyoda and colleagues from Japan established and validated a novel staging system for hepatocellular carcinoma.
The researchers based the staging system on 5 serum markers.
The serum markers include bilirubin, albumin, Lens culinaris agglutinin-reactive α-fetoprotein, α-fetoprotein, and des-γ-carboxy prothrombin.
Subsequently, the researchers termed the staging system the BALAD score.
The team validated the system in 2600 hepatocellular carcinoma patients from 5 institutions.
The potential donors had been excluded and had not undergone surgery.
|Serum and 3 tumor markers accurately predict outcomes|
|Clinical Gastroenterology & Hepatology|
The researchers compared the power of their system to predict patient survival with those of previously reported staging systems.
The team found that the best tumor marker cutoff values were 400 ng/dL for α-fetoprotein, and 15% for Lens culinaris agglutinin-reactive α-fetoprotein.
In addition, the team noted that 100 milli-arbitrary unit/mL was the best tumor marker cutoff value for des-γ-carboxy prothrombin.
The researchers classified the patients into 6 categories on the basis of 5 laboratory values.
The categories reflected patient survival well.
The team observed that the discriminative ability was comparable to that of previously reported staging systems.
Dr Toyoda's team concludes, “The new staging system for hepatocellular carcinoma combining serum albumin, serum bilirubin, and 3 tumor markers predicts patient outcomes with excellent discriminative ability.”
“The system is easy to use and objective.”
“In addition, stage can be evaluated with the use of only 1 serum sample.”
“It also allows global comparison of patients with hepatocellular carcinoma or comparison of patients from different time periods with the same standard.”