Value of Barcelona Clinic Liver Cancer staging system versus Hong Kong Liver Cancer staging system in predicting the prognosis of patients with hepatocellular carcinoma / 临床肝胆病杂志

ABSTRACT

ObjectiveTo investigate the value of Barcelona Clinic Liver Cancer (BCLC) staging system versus Hong Kong Liver Cancer (HKLC) staging system in predicting the prognosis of patients with hepatocellular carcinoma (HCC). MethodsA retrospective analysis was performed for the clinical data of 436 previously untreated patients with HCC who were admitted to The Affiliated Tumor Hospital of Guangxi Medical University from July 2008 to July 2013, and the staging score was determined according to the HKLC and BCLC staging systems. The Kaplan-Meier method was used to plot survival curves, and the log-rank test was used to compare the cumulative survival rate between the patients with different HKLC or BCLC stages. The Cox proportional hazards model was used to calculate the likelihood ratios (LR χ2) of the two systems. The area under the receiver operating characteristic curve (AUC) and C-index were used to analyze the discriminability and trend of the HKLC and BCLC staging systems. ResultsThere was a significant difference in survival rate between the patients with adjacent HKLC stages (all P＜0.05), and there was also a significant difference in survival rate between all patients with adjacent BCLC stages (all P＜0.001), except between those with stage 0 and stage A HCC. The Cox proportional hazards model showed that the HKLC system (LR χ2=131.14) had a better homogeneity than the BCLC system (LR χ2=100.69). The C-index of the BCLC and HKLC systems was 0.703 (95% confidence interval ［CI］ 0.675-0.731) and 0.720 (95% CI 0.692-0.748), respectively, and there was a significant difference in C-index between the two systems (P＜0.001). There was a significant difference in the AUC of 1-year cumulative survival rate between the BCLC system and the HKLC system ［0.783 (95% CI 0.745-0.821) vs 0.811 (95% CI 0774-0849), P=0.026］. ConclusionBoth BCLC and HKLC staging systems have a good value in predicting the prognosis of HCC patients, but the HKLC staging system has a higher value than the BCLC staging system.