Validation and modification of a proposed substaging system for patients with intermediate hepatocellular carcinoma
Validation and modification of a proposed substaging system for patients with intermediate hepatocellular carcinoma
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DOI：
10.1111/jgh.12686
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发表时间：
2015-02-01
影响因子：
4.1
通讯作者：
Lu, Sheng-Nan
中科院分区：
文献类型：
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作者：
Wang, Jing-Houng;Kee, Kwong-Ming;Lu, Sheng-Nan
背景与目的基于7项标准和Child-Pugh评分，将巴塞罗那临床肝癌（BCLC）中间型肝细胞癌（HCC）分为4个亚期。本研究的目的是验证和修改这一提议。方法2002年1月至2011年2月期间，招募了接受经动脉栓塞（TAE）的新诊断中期肝癌患者。患者被分为四个（B1-B4）亚阶段，并随访至死亡或2012年底。比较患者的生存率和亚分期系统的区分能力。B1、B2、B3和B4亚期分别占56.6%、33.8%、7.4%和2.2%。5年生存率分别为21.4%、13.9%、7.4%和7.7%，中位生存时间分别为2.4、1.3、0.5和0.8年（P200 ng/mL，B1分为B1 a和B1 b，B2分为B2 a和B2b。B1 b和B2 a（P=0.174）以及B2b和B3（P=0.785）之间的生存率无差异。将患者重新分类为改良（m）B1（B1 a）、mB 2（B1 b + B2 a）、mB 3（B2b+B3）。改良的亚期（mB 1-mB 3）显示了一个更理想的亚期system.ConclusionsFor BCLC中期HCC患者，亚期B1-B4是有用的预测生存TAE后。然而，改良的亚分期系统提供了更好的预后预测。
Background and AimBased on up-to-seven criteria and Child-Pugh score, four substages of Barcelona Clinic Liver Cancer (BCLC) intermediate hepatocellular carcinoma (HCC) were proposed. The purpose of this study was to validate and modify this proposal.MethodsBetween January 2002 and February 2011, newly diagnosed intermediate HCC patients underwent transarterial embolization (TAE) were enrolled. Patients were stratified into four (B1-B4) substages and followed up until death or end of 2012. Patients' survivals and discriminatory ability of substaging systems were compared.ResultsFive-hundred and eighty patients were enrolled. There were 56.6%, 33.8%, 7.4%, and 2.2% in substage B1, B2, B3, and B4. The 5-year survival rate was 21.4%, 13.9%, 7.4%, and 7.7% with median survival time of 2.4, 1.3, 0.5, and 0.8 years (P200ng/mL, B1 was classified into B1a and B1b, and B2 into B2a and B2b. There were no differences in survivals between B1b and B2a (P=0.174), and B2b and B3 (P=0.785). Patients were re-classified into modified (m)B1 (B1a), mB2 (B1b+B2a), mB3 (B2b+B3). The modified substages (mB1-mB3) showed a more desirable substaging system.ConclusionsFor BCLC intermediate HCC patients, substages B1-B4 were useful in predicting survival after TAE. However, modified substaging system provided better prognostic prediction.