Assessment of the Hong Kong Liver Cancer Staging System in Europe.
- Kolly P Hepatology, Department of Clinical Research, University of Bern, Bern, Switzerland.
- Reeves H The Northern Institute for Cancer Research, Newcastle University, Newcastle-upon-Tyne, UK.
- Sangro B Liver Unit, Clínica Universidad de Navarra and Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Pamplona, España.
- Knöpfli M University Clinic for Visceral Surgery and Medicine, Inselspital Bern, Bern, Switzerland.
- Candinas D University Clinic for Visceral Surgery and Medicine, Inselspital Bern, Bern, Switzerland.
- Dufour JF Hepatology, Department of Clinical Research, University of Bern, Bern, Switzerland.
- 2015-12-19
Published in:
- Liver international : official journal of the International Association for the Study of the Liver. - 2016
BCLC
HKLC
hepatocellular carcinoma
liver cancer
staging
Adolescent
Adult
Aged
Aged, 80 and over
Carcinoma, Hepatocellular
Europe
Female
Humans
Liver
Liver Neoplasms
Male
Middle Aged
Neoplasm Staging
Practice Guidelines as Topic
Prognosis
Prospective Studies
Survival Analysis
Young Adult
English
BACKGROUND & AIMS
European and American guidelines have endorsed the Barcelona Clinic Liver Cancer (BCLC) staging system. The aim of this study was to assess the performance of the recently developed Hong Kong Liver Cancer (HKLC) classification as a staging system for hepatocellular carcinoma (HCC) in Europe.
METHODS
We used a pooled set of 1693 HCC patients combining three prospective European cohorts. Discrimination ability between the nine substages and five stages of the HKLC classification system was assessed. To evaluate the predictive power of the HKLC and BCLC staging systems on overall survival, Nagelkerke pseudo R2, Bayesian Information Criterion and Harrell's concordance index were calculated. The number of patients who would benefit from a curative therapy was assessed for both staging systems.
RESULTS
The HKLC classification in nine substages shows suboptimal discrimination between the staging groups. The classification in five stages shows better discrimination between groups. However, the BCLC classification performs better than the HKLC classification in the ability to predict overall survival (OS). The HKLC treatment algorithm tags significantly more patients to curative therapy than the BCLC.
CONCLUSIONS
The BCLC staging system performs better for European patients than the HKLC staging system in predicting OS. Twice more patients are eligible for a curative therapy with the HKLC algorithm; whether this translates in survival benefit remains to be investigated.
European and American guidelines have endorsed the Barcelona Clinic Liver Cancer (BCLC) staging system. The aim of this study was to assess the performance of the recently developed Hong Kong Liver Cancer (HKLC) classification as a staging system for hepatocellular carcinoma (HCC) in Europe.
METHODS
We used a pooled set of 1693 HCC patients combining three prospective European cohorts. Discrimination ability between the nine substages and five stages of the HKLC classification system was assessed. To evaluate the predictive power of the HKLC and BCLC staging systems on overall survival, Nagelkerke pseudo R2, Bayesian Information Criterion and Harrell's concordance index were calculated. The number of patients who would benefit from a curative therapy was assessed for both staging systems.
RESULTS
The HKLC classification in nine substages shows suboptimal discrimination between the staging groups. The classification in five stages shows better discrimination between groups. However, the BCLC classification performs better than the HKLC classification in the ability to predict overall survival (OS). The HKLC treatment algorithm tags significantly more patients to curative therapy than the BCLC.
CONCLUSIONS
The BCLC staging system performs better for European patients than the HKLC staging system in predicting OS. Twice more patients are eligible for a curative therapy with the HKLC algorithm; whether this translates in survival benefit remains to be investigated.
- Language
-
- English
- Open access status
- green
- Identifiers
-
- DOI 10.1111/liv.13045
- PMID 26677809
- Persistent URL
- https://folia.unifr.ch/global/documents/285489
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