External validation of a simplified BCLC staging system for early hepatocellular carcinoma

Santambrogio, Roberto; Salceda, Juan; Costa, M.; Kluger, Michael D.; Barabino, Matteo; Laurent, Alexis; Opocher, Enrico; Azoulay, Daniel; Cherqui, Daniel

doi:10.1016/j.ejso.2013.05.001

Cited by 19 publications

(10 citation statements)

References 28 publications

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“…Some modifications to various prognostic scores have been made, which appeared to improve prognostic stratification of the Tumor-Node-Metastasis (TNM), Japan Integrated Stage (JIS), and CLIP scores [24][25][26] . A simplified BCLC staging system with the inclusion of AFP was found to be more useful for stratifying 232 early HCC patients and allocating them for hepatic resection [27] .…”

Section: Discussionmentioning

confidence: 99%

Ascites and alpha-fetoprotein improve prognostic performance of Barcelona Clinic Liver Cancer staging

Gomaa

Alkhatib

Abdel-Razek

et al. 2015

WJG

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Section: Discussionmentioning

confidence: 99%

Ascites and alpha-fetoprotein improve prognostic performance of Barcelona Clinic Liver Cancer staging

Gomaa

Alkhatib

Abdel-Razek

et al. 2015

WJG

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“…These include tumor-related factors such as tumor size and extent (number and size of lesions) as well as patient-related factors such as underlying liver function and performance status (PS). The Barcelona Clinic Liver Cancer (BCLC) staging system has been widely used since its inception for this purpose[2], and is the preferred approach by many clinicians for more than a decade due to its treatment recommendations based on stage and its ability to offer predictions on patient survival[3,4]. More recently, the Hong Kong Liver Cancer (HKLC) staging system[5] was developed.…”

Section: Introductionmentioning

confidence: 99%

Barcelona Clinic Liver Cancer outperforms Hong Kong Liver Cancer staging of hepatocellular carcinoma in multiethnic Asians: Real-world perspective

Li¹,

Goh²,

Chang³

et al. 2017

WJG

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AIMTo compare the Barcelona Clinic Liver Cancer (BCLC) and Hong Kong Liver Cancer (HKLC) classification systems when applied to HCC patients from the largest tertiary-level centre in Singapore.METHODSOne thousand two hundred and seventy hepatocellular carcinoma (HCC) patients prospectively enrolled in a tertiary-level centre registry in Singapore since 1988 were studied. Patients were grouped into their respective BCLC and HKLC stages. Data such as demography, aetiology of HCC and type of treatment were collected. Survival data was based on census with the National Registry of Births and Deaths on 31st October 2015. Statistical analyses were done using SPSS version 21 (Chicago, IL, United States). Survival analyses were done by the Kaplan-Meier method. Differences in survival rates were compared using the log-rank test.RESULTSThe median age at presentation was 63 years (range 13-94); male 82.4%; Chinese 89.4%, Malay 7.1%, Indian, 2.8%. Hepatitis B was the predominant aetiology (75.0%; Hepatitis C 7.2%, Hepatitis B and C co-infection 3.8%, non-viral 14.0%). Both BCLC and HKLC staging systems showed good separation with overall log rank test confirming significant survival differences between stages in our cohort (P < 0.001). 206 out of the 240 patients (85.8%) assigned for curative treatment by the BCLC treatment algorithm received curative therapy for HCC [Stage 0 93.2% (68/73); Stage A 82.6% (138/167)]. In contrast, only 341/558 (61.1%) patients received curative treatment despite being assigned for curative treatment by the HKLC treatment algorithm [Stage I 72.7% (264/363); Stage II 40.2% (66/164); Stage Va 35.5% (11/31)]. Patients who were assigned to curative treatment by HKLC but did not receive curative treatment had significantly poorer ECOG (P < 0.001), higher Child-Pugh status (P < 0.001) and were older (median age 66 vs 61, P < 0.001) than those who received curative therapy. Median overall survival in patients assigned to curative treatment groups by BCLC and HKLC were 6.1 and 2.6 years respectively (P < 0.001). When only patients receiving curative treatment were analyzed, BCLC still predicted overall median survival better than HKLC (7.1 years vs 5.5 years, P = 0.037).CONCLUSIONBCLC performs better than HKLC in our multiethnic Asian population in allocating patients to curative treatment in a real-life situation as well as in predicting survival.

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“…The BCLC staging system is the most widely used because it was the first staging system that linked tumour stage to treatment . In addition, several studies have concluded that the BCLC system offers better survival stratification and predictive power than the other staging systems . However, despite its popularity, the BCLC classification system is still criticized for its lack of universal applicability, having been designed using data mostly acquired from a Western population .…”

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confidence: 99%

The recommended treatment algorithms of the BCLC and HKLC staging systems: does following these always improve survival rates for HCC patients?

Kim

Sinn

Jung

et al. 2016

Liver International

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External validation of a simplified BCLC staging system for early hepatocellular carcinoma

Cited by 19 publications

References 28 publications

Ascites and alpha-fetoprotein improve prognostic performance of Barcelona Clinic Liver Cancer staging

Ascites and alpha-fetoprotein improve prognostic performance of Barcelona Clinic Liver Cancer staging

Barcelona Clinic Liver Cancer outperforms Hong Kong Liver Cancer staging of hepatocellular carcinoma in multiethnic Asians: Real-world perspective

The recommended treatment algorithms of the BCLC and HKLC staging systems: does following these always improve survival rates for HCC patients?

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