Evaluation of the prognostic powers of various tumor status grading scales in patients with hepatocellular carcinoma

Yeon Seok Seo, Young Jin Kim, Soon-Ho Um, Hanna Yoo, Jae Won Lee, Yong Sik Kim, Yoon Tae Jeen, Hoon-Jai Chun, Chang Duck Kim, Ho Sang Ryu

Research output: Contribution to journalArticle

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Abstract

Backgrounds and Aim: Several tumor status grading scales are available for patients with hepatocellular carcinoma (HCC), which include several tumor-node-metastasis (TNM) systems and clinical staging systems, such as Cancer of the Liver Italian Program (CLIP) and Barcelona Clinic Liver Cancer (BCLC). This study was performed to analyze the prognostic powers of these tumor status grading systems in HCC. Methods: A retrospective cohort of 499 consecutive patients with HCC was included. The tumor statuses of all patients were classified according to several TNM systems (sixth version of the American Joint Committee on Cancer, fourth version of the Liver Cancer Study Group of Japan [LCSGJ], and the United Network for Organ Sharing UNOS system) and according to the tumor status grading scales of the BCLC (TBCLC) and CLIP (TCLIP) systems. Prognostic powers were quantified using a linear trend χ2-test, c-index, and the likelihood ratio (LHR) χ2-test, and correlated using Cox's regression model adjusted using the Akaike information criterion (AIC). Results: Of the TNM systems, the fourth LCSGJ system had the highest prognostic power (LHR χ2 = 7.20, AIC = 4803.02). However, when TBCLC and TCLIP were included in the analysis, TCLIP showed the best predictive power (LHR χ2 = 29.52, AIC = 4799.82). Conclusion: TCLIP had best predictive power in HCC patients of the various tumor staging systems examined. To improve prognostic power, factors other than tumor burden, such as tumor behavior, should be included in the tumor status grading system for HCC.

Original languageEnglish
Pages (from-to)1267-1275
Number of pages9
JournalJournal of Gastroenterology and Hepatology (Australia)
Volume23
Issue number8 PART1
DOIs
Publication statusPublished - 2008 Jan 1

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Neoplasm Grading
Liver Neoplasms
Hepatocellular Carcinoma
Neoplasms
Neoplasm Metastasis
Japan
Neoplasm Staging
Tumor Burden
Proportional Hazards Models

Keywords

  • Hepatocellular carcinoma
  • Prognostic power
  • Staging system

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

Cite this

Evaluation of the prognostic powers of various tumor status grading scales in patients with hepatocellular carcinoma. / Seo, Yeon Seok; Kim, Young Jin; Um, Soon-Ho; Yoo, Hanna; Lee, Jae Won; Kim, Yong Sik; Jeen, Yoon Tae; Chun, Hoon-Jai; Kim, Chang Duck; Ryu, Ho Sang.

In: Journal of Gastroenterology and Hepatology (Australia), Vol. 23, No. 8 PART1, 01.01.2008, p. 1267-1275.

Research output: Contribution to journalArticle

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abstract = "Backgrounds and Aim: Several tumor status grading scales are available for patients with hepatocellular carcinoma (HCC), which include several tumor-node-metastasis (TNM) systems and clinical staging systems, such as Cancer of the Liver Italian Program (CLIP) and Barcelona Clinic Liver Cancer (BCLC). This study was performed to analyze the prognostic powers of these tumor status grading systems in HCC. Methods: A retrospective cohort of 499 consecutive patients with HCC was included. The tumor statuses of all patients were classified according to several TNM systems (sixth version of the American Joint Committee on Cancer, fourth version of the Liver Cancer Study Group of Japan [LCSGJ], and the United Network for Organ Sharing UNOS system) and according to the tumor status grading scales of the BCLC (TBCLC) and CLIP (TCLIP) systems. Prognostic powers were quantified using a linear trend χ2-test, c-index, and the likelihood ratio (LHR) χ2-test, and correlated using Cox's regression model adjusted using the Akaike information criterion (AIC). Results: Of the TNM systems, the fourth LCSGJ system had the highest prognostic power (LHR χ2 = 7.20, AIC = 4803.02). However, when TBCLC and TCLIP were included in the analysis, TCLIP showed the best predictive power (LHR χ2 = 29.52, AIC = 4799.82). Conclusion: TCLIP had best predictive power in HCC patients of the various tumor staging systems examined. To improve prognostic power, factors other than tumor burden, such as tumor behavior, should be included in the tumor status grading system for HCC.",
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AU - Kim, Young Jin

AU - Um, Soon-Ho

AU - Yoo, Hanna

AU - Lee, Jae Won

AU - Kim, Yong Sik

AU - Jeen, Yoon Tae

AU - Chun, Hoon-Jai

AU - Kim, Chang Duck

AU - Ryu, Ho Sang

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N2 - Backgrounds and Aim: Several tumor status grading scales are available for patients with hepatocellular carcinoma (HCC), which include several tumor-node-metastasis (TNM) systems and clinical staging systems, such as Cancer of the Liver Italian Program (CLIP) and Barcelona Clinic Liver Cancer (BCLC). This study was performed to analyze the prognostic powers of these tumor status grading systems in HCC. Methods: A retrospective cohort of 499 consecutive patients with HCC was included. The tumor statuses of all patients were classified according to several TNM systems (sixth version of the American Joint Committee on Cancer, fourth version of the Liver Cancer Study Group of Japan [LCSGJ], and the United Network for Organ Sharing UNOS system) and according to the tumor status grading scales of the BCLC (TBCLC) and CLIP (TCLIP) systems. Prognostic powers were quantified using a linear trend χ2-test, c-index, and the likelihood ratio (LHR) χ2-test, and correlated using Cox's regression model adjusted using the Akaike information criterion (AIC). Results: Of the TNM systems, the fourth LCSGJ system had the highest prognostic power (LHR χ2 = 7.20, AIC = 4803.02). However, when TBCLC and TCLIP were included in the analysis, TCLIP showed the best predictive power (LHR χ2 = 29.52, AIC = 4799.82). Conclusion: TCLIP had best predictive power in HCC patients of the various tumor staging systems examined. To improve prognostic power, factors other than tumor burden, such as tumor behavior, should be included in the tumor status grading system for HCC.

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KW - Prognostic power

KW - Staging system

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