ClinicalStudiesComparisonofstagingsystemstopredictsurvivalinhepatocellularcarcinomaSoniaPascual1,PedroZapater2,Jose´Such1,AntonioGarcı´a-Herola1,LauraSempere1,JavierIrurzun3,Jose´Marı´aPalazo´n1,FernandoCarnicer1andMiguelPe´rez-Mateo11LiverUnit,2ClinicalPharmacology,3InterventionalRadiologyUnit,HospitalGeneralUniversitariodeAlicante,Alicante,SpainPascualS,ZapaterP,SuchJ,Garcı´a-HerolaA,SempereL,IrurzunJ,Palazo´nJM,CarnicerF,Pe´rez-MateoM.Comparisonofstagingsystemstopredictsurvivalinhepatocellularcarcinoma.LiverInternational2006:26:673–679.r2006TheAuthor.Journalcompilationr2006BlackwellMunksgaardAbstract:Purpose:Somenewstagingsystemsinhepatocellularcarcinoma(HCC)havebeendescribedinthelastyears.Theaimofthisstudywastocomparethesurvival-predictingcapacityofsomevariablesandtheprognosticclassifications.Methods:Demographic,clinical,analyticalvariablesandtumourcharacteristicswerecollectedinastudyincluding115patientswithHCC.PredictorsofsurvivalwereidentifiedusingtheKaplan–MeiertestandtheCoxmodel.Comparisonbetweendifferentstagingsystemswascarriedout.Results:The1-,2-and3-yearestimatedsurvivalwas65%,45%and30%,respectively.Child–Pughscoreanda-fetoproteinlevelgreaterthan400UI/lwereindependentpredictorsofsurvivalintheCoxmodel.Althoughallsystemscorrectlydifferentiatedbetweenpatientsregardingsurvival(Kaplan–Meier,logranko0.05forall),theBarcelonaClinicLiverCancer(BCLC)showedabetterdiscriminatoryabilitythantheotherevaluatedscores.Inaddition,theindependenthomogenizingabilityandstratificationvalueofBCLCwasbetterthanthatofothersystems.Onthecontrary,modelforend-stageliverdisease(MELD)showedtheworstresults.Conclusions:Child–Pughscoreanda-fetoproteinlevelsweretheonlyindependentpredictorsofsurvivalinpatientswithHCC.Child–PughscoreshowedabetterpredictionvalueforsurvivalwhencomparedwithMELD.BCLCismoreaccuratethantheotherprognosticmodelsevaluatedinthisinvestigation.Keywords:hepatocellularcarcinoma–prog-nosis–stagingsystemDr.SoniaPascual,LiverUnit,HospitalGeneralUniversita...
