Clinical appraisal of the recently proposed Barcelona Clinic Liver Cancer stage B subclassification by survival analysis
Clinical appraisal of the recently proposed Barcelona Clinic Liver Cancer stage B subclassification by survival analysis
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DOI：
10.1111/jgh.12452
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发表时间：
2014-04-01
影响因子：
4.1
通讯作者：
Lee, Han Chu
中科院分区：
文献类型：
--
作者：
Ha, Yeonjung;Shim, Ju Hyun;Lee, Han Chu
背景与目的评价埃塔尔提出的巴塞罗那临床肝癌B亚分类（B1-B4）的实用性。根据当前的Barcelona Clinic Liver Cancer policy.MethodsA，总共466例Barcelona Clinic Liver Cancer B患者接受了经动脉化疗栓塞治疗。亚分类系统进行了测试和修改的基础上与生存结局的相关性，这是由Kaplan-Meier法和log-rank test.ResultsThere有101（21.7%），232（49.8%），35（7.5%），和98（21.0%）患者在B1，B2，B3，B4，分别。B1和B2（41.0 vs 22.1个月，P 0.001）、B2和B3（22.1 vs 14.1个月，P=0.004）之间的中位生存时间存在显著差异，但B3和B4之间无显著差异（14.1 vs 17.2个月，P=0.48）。因此，我们开发了一个修改的亚分类，其中B3亚类与B4合并为BIII，BI和BII对应于B1和B2。所有三种改良亚类之间的中位生存时间不同（41.0 vs 22.1 vs 16.6个月，P 0.001），多变量考克斯分析显示改良巴塞罗那诊所肝癌B亚类独立预测总生存期（风险比，BII和BIIII vs BI为1.92和2.78; P
Background and AimTo evaluate the usefulness of Barcelona Clinic Liver Cancer B subclassification (B1-B4) proposed by Bolondi etal. in subjects with hepatocellular carcinoma treated with transarterial chemoembolization according to the current Barcelona Clinic Liver Cancer policy.MethodsA total of 466 Barcelona Clinic Liver Cancer B patients initially treated with transarterial chemoembolization were included. The subclassification system was tested and modified on the basis of correlation with survival outcomes, which were examined by Kaplan-Meier method and log-rank test.ResultsThere were 101 (21.7%), 232 (49.8%), 35 (7.5%), and 98 (21.0%) patients in B1, B2, B3, and B4, respectively. There was a significant difference in median survival time between B1 and B2 (41.0 vs 22.1 months, P0.001), and B2 and B3 (22.1 vs 14.1 months, P=0.004), but not between B3 and B4 (14.1 vs 17.2 months, P=0.48). We, therefore, developed a modified subclassification, in which B3 subclass was merged with B4 as BIII, and BI and BII corresponded to B1 and B2. The median survival times differed between all three modified subclasses (41.0 vs 22.1 vs 16.6 months, P0.001), and multivariate Cox analysis revealed that the modified Barcelona Clinic Liver Cancer B subclasses independently predicted overall survival (hazard ratios, 1.92 and 2.78 for BII and BIIIvsBI; P