Comparison between the fifth and sixth editions of the AJCC/UICC TNM staging systems for hepatocellular carcinoma: multicentric study on 393 cirrhotic resected patients
Comparison between the fifth and sixth editions of the AJCC/UICC TNM staging systems for hepatocellular carcinoma: multicentric study on 393 cirrhotic resected patients
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DOI：
10.1016/j.ejso.2005.04.008
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发表时间：
2005-09-01
期刊：
影响因子：
3.8
通讯作者：
Pinna, A
中科院分区：
文献类型：
--
作者：
Varotti, G;Ramacciato, G;Pinna, A
目的：比较第 5 版和第 6 版 HCC TNM 分期系统的预后效果。方法：我们回顾性地将新旧系统应用于 393 例切除的患者，比较两者的预后评估效果。结果：1 年、3 年和 5 年总生存率。比率分别为 89.7%、71.1% 和 56.3%。 1年、3年和5年无病生存率分别为79.4%、54.6%和39.4%。在评估的因素中，Child 的 B 级和 C 级（p=0.001）以及多个结节的存在（p=0.01）被发现与较差的长期生存率相关。或更差的无病生存率。根据旧的 TNM 系统对患者生存进行分层，我们发现仅 II 期和 IIIA 期之间存在显着差异 (p=0.001)；否则，I 期和 II 期 (p=0.9) 以及 IIIA 期和 IVA 期 (p=0.9) 表现出相似的生存率。分析新的 TNM 系统，我们发现分期分层更加均匀，I 期和 II 期之间 (p=0.02) 以及 II 期和 IIIA 期之间 (p=0.05) 之间存在显着差异。 结论：在本项多中心研究中，肝移植后的长期总体生存率和无病生存率 HCC 的切除受到肿瘤数量和潜在肝脏疾病的强烈影响。我们的结果表明，新的分类似乎实现了患者的准确分层，比之前的版本更简单，并且对 HCC 肝切除术后的结果进行了更可靠的比较分析。 (c) 2005 Elsevier Ltd. 保留所有权利。
Aims: To compare the prognostic efficacy of the 5th and 6th edition of the TNM staging system for HCC.Methods: We retrospectively applied the old and the new systems to 393 resected patients, comparing the efficacy of both in prognostic evaluation.Results: The 1-, 3- and 5-year overall survival. rates were 89.7, 71.1 and 56.3%, respectively. The 1-, 3- and 5-year disease-free survival rates were 79.4, 54.6 and 39.4%, respectively. Among the factors evaluated, Child's grade B and C (p=0.001) and presence of multiple nodules (p=0.01) were found to be related either to a worse long-term survival. or to a worse disease-free survival. Stratifying patient survivals according to the old TNM system, we found significant differences only between stages II and IIIA (p=0.001); otherwise stages I and II (p=0.9) as well as stages IIIA and IVA (p=0.9) showed similar survival rates.Analysing the new TNM system, we found a more homogeneous staging stratification, with significant differences both between stage I and II (p=0.02) and between stage II and IIIA (p=0.05).Conclusions: In the present multicentric study, tong term overall and disease-free survival after liver resection for HCC was strongly affected by the number of tumours and the underlying liver disease. Our results suggest that the new classification appears to achieve an accurate stratification of patients, simpler than the previous edition, as well as a more reliable comparative analysis of outcome after hepatic resection for HCC. (c) 2005 Elsevier Ltd. All rights reserved.