Comparison of five staging systems in hepatocellular carcinoma treated with sorafenib: A single-center experience

Abstract

Abstract. To the best of our knowledge, none of the prognostic staging systems for hepatocellular carcinoma (HCC) patients who underwent sorafenib therapy is universally adopted or preferred. In the present study, we aimed to compare prognostic ability among five prognostic systems, including the Japan Integrated Staging (JIS) system, the Barcelona Clinic Liver Cancer classification system, the tumor-node-metastasis classification system, the Cancer of the Liver Italian Program scoring system and the Chinese University Prognostic Index (CUPI) scoring system for HCC patients who received sorafenib therapy. A total of 143 HCC patients treated with sorafenib were analysed. We compared prognostic ability among the five prognostic systems using the likelihood ratio (LR) χ 2 test, linear trend χ 2 test and concordance index (c-index). Our cohort included 114 men and 29 women. The median patient age was 71 years (range, 45-89 years). A total of 102 patients were classified as Child-Pugh A and 41 as Child-Pugh B, whereas 31 patients (21.7%) had portal vein invasion and 63 (44.1%) extrahepatic metastases. The median survival time was 6.9 months. In the LR χ 2 test, the CUPI scoring system had the highest value (35.804), followed by the JIS system (17.469). In the linear trend χ 2 test, the CUPI scoring system had the highest value (17.523), followed by the JIS system (15.819). In addition, the JIS system had the highest value in the 6-month c-index (0.659) as well as in the 1-year c-index (0.674). However, the CUPI classification system had the lowest value in the 1-year c-index (0.590). In conclusion, the JIS system may be an appropriate staging system for HCC patients undergoing sorafenib therapy.

Prognosis of patients with hepatocellular carcinoma treated with sorafenib: a comparison of five models in a large Canadian database

“…When compared to the other models, CLIP was the best system in terms of homogeneity within the same stage, monotonicity of gradients and had the highest predictive ability. This finding is supported by previous studies but challenged in another report . However, the latter study was limited by a small number of patients, and it was restricted to East Asian patients with HCC.…”

“…The main strength is its large multicenter design which included significant numbers of both Western and East Asian patients with a variety of liver disease etiologies all of whom were treated similarly at different Canadian cancer centers. This addressed common limitations in a number of published retrospective studies [17,22,25,27]. A further advantage is that the staging systems were evaluated with respect to their performance and overall predictive value.…”