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Cited 2 time in webofscience Cited 2 time in scopus
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Prognostic assessment using a new substaging system for Barcelona clinic liver cancer stage C hepatocellular carcinoma: A nationwide study

Authors
Lee, Dong-wonYim, Hyung JoonSeo, Yeon SeokNa, Seong KyunKim, Seung YoungSuh, Sang JunHyun, Jong JinJung, Sung WooJung, Young KulKoo, Ja SeolKim, Ji HoonYeon, Jong EunLee, Sang WooByun, Kwan SooUm, Soon Ho
Issue Date
Jun-2019
Publisher
Blackwell Publishing Inc.
Keywords
hepatocellular carcinoma; prognosis; stage; substaging; treatment
Citation
Liver International, v.39, no.6, pp.1109 - 1119
Indexed
SCIE
SCOPUS
Journal Title
Liver International
Volume
39
Number
6
Start Page
1109
End Page
1119
URI
https://scholarworks.korea.ac.kr/kumedicine/handle/2020.sw.kumedicine/1954
DOI
10.1111/liv.14117
ISSN
1478-3223
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.
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Koo, Ja Seol
Ansan Hospital (Department of Gastroenterology and Hepatology, Ansan Hospital)
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