Cargando…

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

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 st...

Descripción completa

Detalles Bibliográficos
Autores principales: Lee, Young-Sun, Seo, Yeon Seok, Kim, Ji Hoon, Lee, Juneyoung, Kim, Hae Rim, Yoo, Yang Jae, Kim, Tae Suk, Kang, Seong Hee, Suh, Sang Jun, Joo, Moon Kyung, Jung, Young Kul, Lee, Beom Jae, Yim, Hyung Joon, Yeon, Jong Eun, Kim, Jae Seon, Park, Jong-Jae, Um, Soon Ho, Bak, Young-Tae, Byun, Kwan Soo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Editorial Office of Gut and Liver 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5753690/
https://www.ncbi.nlm.nih.gov/pubmed/28873509
http://dx.doi.org/10.5009/gnl17040
_version_ 1783290319603761152
author Lee, Young-Sun
Seo, Yeon Seok
Kim, Ji Hoon
Lee, Juneyoung
Kim, Hae Rim
Yoo, Yang Jae
Kim, Tae Suk
Kang, Seong Hee
Suh, Sang Jun
Joo, Moon Kyung
Jung, Young Kul
Lee, Beom Jae
Yim, Hyung Joon
Yeon, Jong Eun
Kim, Jae Seon
Park, Jong-Jae
Um, Soon Ho
Bak, Young-Tae
Byun, Kwan Soo
author_facet Lee, Young-Sun
Seo, Yeon Seok
Kim, Ji Hoon
Lee, Juneyoung
Kim, Hae Rim
Yoo, Yang Jae
Kim, Tae Suk
Kang, Seong Hee
Suh, Sang Jun
Joo, Moon Kyung
Jung, Young Kul
Lee, Beom Jae
Yim, Hyung Joon
Yeon, Jong Eun
Kim, Jae Seon
Park, Jong-Jae
Um, Soon Ho
Bak, Young-Tae
Byun, Kwan Soo
author_sort Lee, Young-Sun
collection PubMed
description 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.
format Online
Article
Text
id pubmed-5753690
institution National Center for Biotechnology Information
language English
publishDate 2018
publisher Editorial Office of Gut and Liver
record_format MEDLINE/PubMed
spelling pubmed-57536902018-01-19 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 Lee, Young-Sun Seo, Yeon Seok Kim, Ji Hoon Lee, Juneyoung Kim, Hae Rim Yoo, Yang Jae Kim, Tae Suk Kang, Seong Hee Suh, Sang Jun Joo, Moon Kyung Jung, Young Kul Lee, Beom Jae Yim, Hyung Joon Yeon, Jong Eun Kim, Jae Seon Park, Jong-Jae Um, Soon Ho Bak, Young-Tae Byun, Kwan Soo Gut Liver Original Article 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. Editorial Office of Gut and Liver 2018-01 2017-09-07 /pmc/articles/PMC5753690/ /pubmed/28873509 http://dx.doi.org/10.5009/gnl17040 Text en Copyright © 2018 by The Korean Society of Gastroenterology, the Korean Society of Gastrointestinal Endoscopy, the Korean Society of Neurogastroenterology and Motility, Korean College of Helicobacter and Upper Gastrointestinal Research, Korean Association the Study of Intestinal Diseases, the Korean Association for the Study of the Liver, Korean Pancreatobiliary Association, and Korean Society of Gastrointestinal Cancer. This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Lee, Young-Sun
Seo, Yeon Seok
Kim, Ji Hoon
Lee, Juneyoung
Kim, Hae Rim
Yoo, Yang Jae
Kim, Tae Suk
Kang, Seong Hee
Suh, Sang Jun
Joo, Moon Kyung
Jung, Young Kul
Lee, Beom Jae
Yim, Hyung Joon
Yeon, Jong Eun
Kim, Jae Seon
Park, Jong-Jae
Um, Soon Ho
Bak, Young-Tae
Byun, Kwan Soo
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
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
title_full 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
title_fullStr 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
title_full_unstemmed 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
title_short 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
title_sort 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
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5753690/
https://www.ncbi.nlm.nih.gov/pubmed/28873509
http://dx.doi.org/10.5009/gnl17040
work_keys_str_mv AT leeyoungsun canmoreaggressivetreatmentimproveprognosisinpatientswithhepatocellularcarcinomaadirectcomparisonofthehongkonglivercancerandbarcelonacliniclivercanceralgorithms
AT seoyeonseok canmoreaggressivetreatmentimproveprognosisinpatientswithhepatocellularcarcinomaadirectcomparisonofthehongkonglivercancerandbarcelonacliniclivercanceralgorithms
AT kimjihoon canmoreaggressivetreatmentimproveprognosisinpatientswithhepatocellularcarcinomaadirectcomparisonofthehongkonglivercancerandbarcelonacliniclivercanceralgorithms
AT leejuneyoung canmoreaggressivetreatmentimproveprognosisinpatientswithhepatocellularcarcinomaadirectcomparisonofthehongkonglivercancerandbarcelonacliniclivercanceralgorithms
AT kimhaerim canmoreaggressivetreatmentimproveprognosisinpatientswithhepatocellularcarcinomaadirectcomparisonofthehongkonglivercancerandbarcelonacliniclivercanceralgorithms
AT yooyangjae canmoreaggressivetreatmentimproveprognosisinpatientswithhepatocellularcarcinomaadirectcomparisonofthehongkonglivercancerandbarcelonacliniclivercanceralgorithms
AT kimtaesuk canmoreaggressivetreatmentimproveprognosisinpatientswithhepatocellularcarcinomaadirectcomparisonofthehongkonglivercancerandbarcelonacliniclivercanceralgorithms
AT kangseonghee canmoreaggressivetreatmentimproveprognosisinpatientswithhepatocellularcarcinomaadirectcomparisonofthehongkonglivercancerandbarcelonacliniclivercanceralgorithms
AT suhsangjun canmoreaggressivetreatmentimproveprognosisinpatientswithhepatocellularcarcinomaadirectcomparisonofthehongkonglivercancerandbarcelonacliniclivercanceralgorithms
AT joomoonkyung canmoreaggressivetreatmentimproveprognosisinpatientswithhepatocellularcarcinomaadirectcomparisonofthehongkonglivercancerandbarcelonacliniclivercanceralgorithms
AT jungyoungkul canmoreaggressivetreatmentimproveprognosisinpatientswithhepatocellularcarcinomaadirectcomparisonofthehongkonglivercancerandbarcelonacliniclivercanceralgorithms
AT leebeomjae canmoreaggressivetreatmentimproveprognosisinpatientswithhepatocellularcarcinomaadirectcomparisonofthehongkonglivercancerandbarcelonacliniclivercanceralgorithms
AT yimhyungjoon canmoreaggressivetreatmentimproveprognosisinpatientswithhepatocellularcarcinomaadirectcomparisonofthehongkonglivercancerandbarcelonacliniclivercanceralgorithms
AT yeonjongeun canmoreaggressivetreatmentimproveprognosisinpatientswithhepatocellularcarcinomaadirectcomparisonofthehongkonglivercancerandbarcelonacliniclivercanceralgorithms
AT kimjaeseon canmoreaggressivetreatmentimproveprognosisinpatientswithhepatocellularcarcinomaadirectcomparisonofthehongkonglivercancerandbarcelonacliniclivercanceralgorithms
AT parkjongjae canmoreaggressivetreatmentimproveprognosisinpatientswithhepatocellularcarcinomaadirectcomparisonofthehongkonglivercancerandbarcelonacliniclivercanceralgorithms
AT umsoonho canmoreaggressivetreatmentimproveprognosisinpatientswithhepatocellularcarcinomaadirectcomparisonofthehongkonglivercancerandbarcelonacliniclivercanceralgorithms
AT bakyoungtae canmoreaggressivetreatmentimproveprognosisinpatientswithhepatocellularcarcinomaadirectcomparisonofthehongkonglivercancerandbarcelonacliniclivercanceralgorithms
AT byunkwansoo canmoreaggressivetreatmentimproveprognosisinpatientswithhepatocellularcarcinomaadirectcomparisonofthehongkonglivercancerandbarcelonacliniclivercanceralgorithms