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

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5 Citations (Scopus)

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<0.001). 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.

Original languageEnglish
Pages (from-to)94-101
Number of pages8
JournalGut and Liver
Volume12
Issue number1
DOIs
Publication statusPublished - 2018 Jan 1

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Hong Kong
Liver Neoplasms
Hepatocellular Carcinoma
Neoplasm Staging
Therapeutics
Survival
Guidelines
Korea
ROC Curve

Keywords

  • Barcelona clinic liver cancer
  • Carcinoma
  • Hepatocellular
  • Hong Kong liver cancer
  • Neoplasm staging

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

Cite this

@article{ec92b27457fe4d88938f4ad75ff21a92,
title = "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",
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<0.001). 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.",
keywords = "Barcelona clinic liver cancer, Carcinoma, Hepatocellular, Hong Kong liver cancer, Neoplasm staging",
author = "Young-Sun Lee and Seo, {Yeon Seok} and Kim, {Ji Hoon} and Juneyoung Lee and Kim, {Hae Rim} and Yoo, {Yang Jae} and Kim, {Tae Suk} and Kang, {Seong Hee} and Suh, {Sang Jun} and Joo, {Moon Kyung} and Jung, {Young Kul} and Beomjae Lee and Yim, {Hyung Joon} and Yeon, {Jong Eun} and Kim, {Jae Seon} and Park, {Jong Jae} and Soon-Ho Um and Bak, {Young Tae} and Byun, {Kwan Soo}",
year = "2018",
month = "1",
day = "1",
doi = "10.5009/gnl17040",
language = "English",
volume = "12",
pages = "94--101",
journal = "Gut and Liver",
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TY - JOUR

T1 - 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

AU - Lee, Young-Sun

AU - Seo, Yeon Seok

AU - Kim, Ji Hoon

AU - Lee, Juneyoung

AU - Kim, Hae Rim

AU - Yoo, Yang Jae

AU - Kim, Tae Suk

AU - Kang, Seong Hee

AU - Suh, Sang Jun

AU - Joo, Moon Kyung

AU - Jung, Young Kul

AU - Lee, Beomjae

AU - Yim, Hyung Joon

AU - Yeon, Jong Eun

AU - Kim, Jae Seon

AU - Park, Jong Jae

AU - Um, Soon-Ho

AU - Bak, Young Tae

AU - Byun, Kwan Soo

PY - 2018/1/1

Y1 - 2018/1/1

N2 - 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<0.001). 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.

AB - 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<0.001). 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.

KW - Barcelona clinic liver cancer

KW - Carcinoma

KW - Hepatocellular

KW - Hong Kong liver cancer

KW - Neoplasm staging

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U2 - 10.5009/gnl17040

DO - 10.5009/gnl17040

M3 - Article

C2 - 28873509

AN - SCOPUS:85040517115

VL - 12

SP - 94

EP - 101

JO - Gut and Liver

JF - Gut and Liver

SN - 1976-2283

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