Prognostic assessment using a new substaging system for Barcelona clinic liver cancer stage C hepatocellular carcinoma: A nationwide study

Dong won Lee; Hyung Joon Yim; Yeon Seok Seo; Seong Kyun Na; Seung Young Kim; Sang Jun Suh; Jong Jin Hyun; Sung Woo Jung; Young Kul Jung; Ja Seol Koo; Ji Hoon Kim; Jong Eun Yeon; Sang Woo Lee; Kwan Soo Byun; Soon Ho Um

doi:10.1111/liv.14117

Prognostic assessment using a new substaging system for Barcelona clinic liver cancer stage C hepatocellular carcinoma: A nationwide study

Dong won Lee, Hyung Joon Yim, Yeon Seok Seo, Seong Kyun Na, Seung Young Kim, Sang Jun Suh, Jong Jin Hyun, Sung Woo Jung, Young Kul Jung, Ja Seol Koo, Ji Hoon Kim, Jong Eun Yeon, Sang Woo Lee, Kwan Soo Byun, Soon Ho Um

Research output: Contribution to journal › Article › peer-review

2 Citations (Scopus)

Abstract

Aim & Background: Advanced hepatocellular carcinoma (HCC) (Barcelona clinic liver cancer [BCLC] stage C) needs subclassification to more accurately predict survival. This study aims to establish a substaging system of BCLC stage C HCC patients for accurate prognosis. Methods: Data from 564 patients with newly diagnosed BCLC stage C HCC from three tertiary-care hospitals affiliated with the Korea University (training set) were assessed retrospectively. Variables affecting overall survival (OS) were analysed, and patients were substaged according to the number of prognostic factors they fulfilled. The substaging system was validated using a nationwide database from the Korean Liver Cancer Association (validation set; n = 742). Results: In the training set, tumour factors such as tumour burden ≥10 cm, major portal vein invasion and distant metastasis, as well as underlying liver function, were independently associated with OS. BCLC stage C was classified into four substages (C1-4) according to the number of prognostic factors. Substages C1, C2, C3 and C4 showed a median OS of 17.50 months (95% confidence interval [CI], 8.57-26.43), 10.13 months (95% CI, 8.17-12.09), 4.20 months (95% CI, 3.42-4.98), and 2.90 months (95% CI, 2.34-3.46) respectively (P < 0.05). This substaging system also had good discriminative ability in predicting survival in the validation set. In addition, it was considered that the BCLC substaging is better than Hong Kong liver cancer substaging in predicting the OS for patients with advanced HCC. Conclusion: Our substaging for BCLC stage C might help predict patients' prognosis better.

Original language	English
Pages (from-to)	1109-1119
Number of pages	11
Journal	Liver International
Volume	39
Issue number	6
DOIs	https://doi.org/10.1111/liv.14117
Publication status	Published - 2019 Jun

Keywords

hepatocellular carcinoma
prognosis
stage
substaging
treatment

ASJC Scopus subject areas

Hepatology

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1111/liv.14117

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Lee, D. W., Yim, H. J., Seo, Y. S., Na, S. K., Kim, S. Y., Suh, S. J., Hyun, J. J., Jung, S. W., Jung, Y. K., Koo, J. S., Kim, J. H., Yeon, J. E., Lee, S. W., Byun, K. S., & Um, S. H. (2019). Prognostic assessment using a new substaging system for Barcelona clinic liver cancer stage C hepatocellular carcinoma: A nationwide study. Liver International, 39(6), 1109-1119. https://doi.org/10.1111/liv.14117

Lee, DW, Yim, HJ, Seo, YS, Na, SK, Kim, SY, Suh, SJ, Hyun, JJ, Jung, SW, Jung, YK, Koo, JS, Kim, JH, Yeon, JE, Lee, SW, Byun, KS & Um, SH 2019, 'Prognostic assessment using a new substaging system for Barcelona clinic liver cancer stage C hepatocellular carcinoma: A nationwide study', Liver International, vol. 39, no. 6, pp. 1109-1119. https://doi.org/10.1111/liv.14117

@article{27696156d50b4639882cd92431a16d6b,

title = "Prognostic assessment using a new substaging system for Barcelona clinic liver cancer stage C hepatocellular carcinoma: A nationwide study",

abstract = "Aim & Background: Advanced hepatocellular carcinoma (HCC) (Barcelona clinic liver cancer [BCLC] stage C) needs subclassification to more accurately predict survival. This study aims to establish a substaging system of BCLC stage C HCC patients for accurate prognosis. Methods: Data from 564 patients with newly diagnosed BCLC stage C HCC from three tertiary-care hospitals affiliated with the Korea University (training set) were assessed retrospectively. Variables affecting overall survival (OS) were analysed, and patients were substaged according to the number of prognostic factors they fulfilled. The substaging system was validated using a nationwide database from the Korean Liver Cancer Association (validation set; n = 742). Results: In the training set, tumour factors such as tumour burden ≥10 cm, major portal vein invasion and distant metastasis, as well as underlying liver function, were independently associated with OS. BCLC stage C was classified into four substages (C1-4) according to the number of prognostic factors. Substages C1, C2, C3 and C4 showed a median OS of 17.50 months (95% confidence interval [CI], 8.57-26.43), 10.13 months (95% CI, 8.17-12.09), 4.20 months (95% CI, 3.42-4.98), and 2.90 months (95% CI, 2.34-3.46) respectively (P < 0.05). This substaging system also had good discriminative ability in predicting survival in the validation set. In addition, it was considered that the BCLC substaging is better than Hong Kong liver cancer substaging in predicting the OS for patients with advanced HCC. Conclusion: Our substaging for BCLC stage C might help predict patients' prognosis better.",

keywords = "hepatocellular carcinoma, prognosis, stage, substaging, treatment",

author = "Lee, {Dong won} and Yim, {Hyung Joon} and Seo, {Yeon Seok} and Na, {Seong Kyun} and Kim, {Seung Young} and Suh, {Sang Jun} and Hyun, {Jong Jin} and Jung, {Sung Woo} and Jung, {Young Kul} and Koo, {Ja Seol} and Kim, {Ji Hoon} and Yeon, {Jong Eun} and Lee, {Sang Woo} and Byun, {Kwan Soo} and Um, {Soon Ho}",

note = "Funding Information: Funding information Funded by the Korea University Research Grant. The data in the validation set were collected by the Korean Central Cancer Registry, Ministry of Health and Welfare, South Korea, and the Korean Liver Cancer Association. The authors thank the Korean Liver Cancer Association for providing an invaluable nationwide liver cancer dataset. Funding Information: Funded by the Korea University Research Grant. Publisher Copyright: {\textcopyright} 2019 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd",

year = "2019",

month = jun,

doi = "10.1111/liv.14117",

language = "English",

volume = "39",

pages = "1109--1119",

journal = "Liver International",

issn = "1478-3223",

publisher = "Wiley-Blackwell",

number = "6",

}

TY - JOUR

T1 - Prognostic assessment using a new substaging system for Barcelona clinic liver cancer stage C hepatocellular carcinoma

T2 - A nationwide study

AU - Lee, Dong won

AU - Yim, Hyung Joon

AU - Seo, Yeon Seok

AU - Na, Seong Kyun

AU - Kim, Seung Young

AU - Suh, Sang Jun

AU - Hyun, Jong Jin

AU - Jung, Sung Woo

AU - Jung, Young Kul

AU - Koo, Ja Seol

AU - Kim, Ji Hoon

AU - Yeon, Jong Eun

AU - Lee, Sang Woo

AU - Byun, Kwan Soo

AU - Um, Soon Ho

N1 - Funding Information: Funding information Funded by the Korea University Research Grant. The data in the validation set were collected by the Korean Central Cancer Registry, Ministry of Health and Welfare, South Korea, and the Korean Liver Cancer Association. The authors thank the Korean Liver Cancer Association for providing an invaluable nationwide liver cancer dataset. Funding Information: Funded by the Korea University Research Grant. Publisher Copyright: © 2019 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd

PY - 2019/6

Y1 - 2019/6

N2 - Aim & Background: Advanced hepatocellular carcinoma (HCC) (Barcelona clinic liver cancer [BCLC] stage C) needs subclassification to more accurately predict survival. This study aims to establish a substaging system of BCLC stage C HCC patients for accurate prognosis. Methods: Data from 564 patients with newly diagnosed BCLC stage C HCC from three tertiary-care hospitals affiliated with the Korea University (training set) were assessed retrospectively. Variables affecting overall survival (OS) were analysed, and patients were substaged according to the number of prognostic factors they fulfilled. The substaging system was validated using a nationwide database from the Korean Liver Cancer Association (validation set; n = 742). Results: In the training set, tumour factors such as tumour burden ≥10 cm, major portal vein invasion and distant metastasis, as well as underlying liver function, were independently associated with OS. BCLC stage C was classified into four substages (C1-4) according to the number of prognostic factors. Substages C1, C2, C3 and C4 showed a median OS of 17.50 months (95% confidence interval [CI], 8.57-26.43), 10.13 months (95% CI, 8.17-12.09), 4.20 months (95% CI, 3.42-4.98), and 2.90 months (95% CI, 2.34-3.46) respectively (P < 0.05). This substaging system also had good discriminative ability in predicting survival in the validation set. In addition, it was considered that the BCLC substaging is better than Hong Kong liver cancer substaging in predicting the OS for patients with advanced HCC. Conclusion: Our substaging for BCLC stage C might help predict patients' prognosis better.

AB - Aim & Background: Advanced hepatocellular carcinoma (HCC) (Barcelona clinic liver cancer [BCLC] stage C) needs subclassification to more accurately predict survival. This study aims to establish a substaging system of BCLC stage C HCC patients for accurate prognosis. Methods: Data from 564 patients with newly diagnosed BCLC stage C HCC from three tertiary-care hospitals affiliated with the Korea University (training set) were assessed retrospectively. Variables affecting overall survival (OS) were analysed, and patients were substaged according to the number of prognostic factors they fulfilled. The substaging system was validated using a nationwide database from the Korean Liver Cancer Association (validation set; n = 742). Results: In the training set, tumour factors such as tumour burden ≥10 cm, major portal vein invasion and distant metastasis, as well as underlying liver function, were independently associated with OS. BCLC stage C was classified into four substages (C1-4) according to the number of prognostic factors. Substages C1, C2, C3 and C4 showed a median OS of 17.50 months (95% confidence interval [CI], 8.57-26.43), 10.13 months (95% CI, 8.17-12.09), 4.20 months (95% CI, 3.42-4.98), and 2.90 months (95% CI, 2.34-3.46) respectively (P < 0.05). This substaging system also had good discriminative ability in predicting survival in the validation set. In addition, it was considered that the BCLC substaging is better than Hong Kong liver cancer substaging in predicting the OS for patients with advanced HCC. Conclusion: Our substaging for BCLC stage C might help predict patients' prognosis better.

KW - hepatocellular carcinoma

KW - prognosis

KW - stage

KW - substaging

KW - treatment

UR - http://www.scopus.com/inward/record.url?scp=85065490770&partnerID=8YFLogxK

U2 - 10.1111/liv.14117

DO - 10.1111/liv.14117

M3 - Article

C2 - 30972935

AN - SCOPUS:85065490770

SN - 1478-3223

VL - 39

SP - 1109

EP - 1119

JO - Liver International

JF - Liver International

IS - 6

ER -

Prognostic assessment using a new substaging system for Barcelona clinic liver cancer stage C hepatocellular carcinoma: A nationwide study

Abstract

Keywords

ASJC Scopus subject areas

UN SDGs

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