External validation of a simplified BCLC staging system for early hepatocellular carcinoma.
Eur J Surg Oncol
; 39(8): 850-7, 2013 Aug.
Article
em En
| MEDLINE
| ID: mdl-23726257
BACKGROUND AND AIMS: The aim was to externally validate the capability of a simplified Barcelona Clinic Liver Cancer (s-BCLC) staging system in allocating patients to hepatic resection (HR) and the effect on survival: S-BCLC was defined by only 2 groups: AA included BCLC A1 + A2 classes with alpha-fetoprotein (AFP) ≤ 20 ng/ml and AB included A1 + A2 with AFP > 20 ng/ml plus A3 + A4 subgroups. METHODS: This study compared a training group (TG) with hepatocellular carcinoma (HCC) submitted to hepatic resection (HR) in Milan with another group of patients, the validation group (VG) in Creteil. All patients underwent ultrasound-guided anatomical resection (<3 segments). RESULTS: Overall survival got worse from A1 to A4 (p = 0.0271) in TG (n = 132), as well as in VG (n = 100) (p = 0.0044) with a more important overlapping of each curves. According s-BCLC classification, the survival curves of TG (p = 0.0001) and VG (p = 0.0250) showed a definitive separation in two different staging groups. The s-BCLC provided the best predictive accuracy and it also presented the highest separability index and C-statistics in both TG and VG. On the other hand, in the evaluation of discriminatory ability for death, measured by ROC curve areas, the s-BCLC system gave better results than the others. CONCLUSION: This experience stressed the high value of BCLC system in staging of HCC, but the s-BCLC system seems to be more useful for therapeutic decision making.
Palavras-chave
AASLD; AFP; American Association for the Study of Liver Diseases; BCLC; Barcelona Clinic Liver Cancer; HCC; HR; Hepatic resection; Hepato-Pancreato-Biliary Association; Hepatocellular carcinoma; IHPBA; IOUS; LCSGJ; Laparoscopy; Liver Cancer Study Group of Japan; Liver cancer; Liver cirrhosis; Radiofrequency ablation; Staging system; TG; Training group; VG; Validation group; alpha-fetoprotein; hepatic resection; hepatocellular carcinoma; intraoperative ultrasonography; s-BCLC; simplified system for BCLC stage A
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Alfa-Fetoproteínas
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Carcinoma Hepatocelular
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Hepatectomia
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Neoplasias Hepáticas
Tipo de estudo:
Diagnostic_studies
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Etiology_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
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Screening_studies
Limite:
Adult
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Aged
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Female
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Humans
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Male
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Middle aged
País/Região como assunto:
Europa
Idioma:
En
Ano de publicação:
2013
Tipo de documento:
Article