Is there an ideal prognostic classification for hepatocellular carcinoma? The quest for the Holy Grail

Trinchet, Jean–Claude; Beaugrand, Michel

doi:10.1016/j.jhep.2010.04.002

Cited by 7 publications

(6 citation statements)

References 22 publications

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“…To further evaluate the diagnostic performance of MDK in early detection and diagnosis of hepatocellular carcinomas, we next focused on a subset of patients with negative AFP and early-stage hepatocellular carcinomas in cohort A. BCLC stage system, the currently widely accepted prognostic classification system for hepatocellular carcinomas (24, 25), was adopted in our study. ROC curve analysis suggested that serum MDK had a better performance compared with AFP for distinguishing early-stage hepatocellular carcinomas as well as small hepatocellular carcinomas (tumor size < 5cm) from non–hepatocellular carcinoma controls including liver cirrhosis (Fig.…”

Section: Resultsmentioning

confidence: 99%

Evaluation of Midkine as a Diagnostic Serum Biomarker in Hepatocellular Carcinoma

Zhu

Jia

Guo

et al. 2013

Clinical Cancer Research

119

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Purpose: To evaluate the value of serum midkine (MDK) as a diagnostic biomarker in hepatocellular carcinoma, particularly for those with negative alpha-fetoprotein (AFP) and at an early stage.Experimental Design: MDK expression in tumors was assessed by immunohistochemistry from 105 patients with hepatocellular carcinomas or liver cirrhosis. Serum MDK levels were detected by ELISA in 933 participants including hepatocellular carcinomas and hospital controls from different medical centers. Sensitivities and specificities of serum MDK in diagnosing hepatocellular carcinoma according to AFP level and Barcelona Clinic Liver Cancer (BCLC) stage were analyzed.Results: MDK levels were significantly elevated in hepatocellular carcinoma tissues as well as serum samples. The sensitivity of serum MDK for hepatocellular carcinoma diagnosis was much higher than that of AFP (86.9% vs. 51.9%) with similar specificities (83.9% vs. 86.3%). Notably, serum MDK had an outstanding performance in distinguishing AFP-negative hepatocellular carcinomas from different controls: In those AFP-negative hepatocellular carcinomas, the sensitivity could reach as high as 89.2%. Moreover, receiver operating characteristic (ROC) curve analysis also showed that serum MDK had a better performance compared with AFP in distinguishing early-stage hepatocellular carcinomas as well as small hepatocellular carcinomas. Even in very early-stage hepatocellular carcinomas, MDK showed an obviously higher sensitivity compared with AFP (80% vs. 40%). Furthermore, serum MDK level was significantly decreased in patients with hepatocellular carcinomas after curative resection and re-elevated when tumor relapse occurred.Conclusions: Serum MDK is significantly elevated in most hepatocellular carcinomas, including those with negative AFP and at an early stage, which may serve as a novel diagnostic marker in early diagnosis and postoperative monitoring of hepatocellular carcinomas.

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Section: Resultsmentioning

confidence: 99%

Evaluation of Midkine as a Diagnostic Serum Biomarker in Hepatocellular Carcinoma

Zhu

Jia

Guo

et al. 2013

Clinical Cancer Research

119

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“…Several tools to predict prognosis have been proposed (Okuda, TNM, CLIP, CUPI, HK and JIS classifications), yet each of these tools have been criticized. [3][4][5][6][7][8][9][10] For example, widely used staging systems such as the Barcelona Clinic Liver Cancer (BCLC) classification recommends surgical resection for single or multiple tumours (up to 3 nodules, 3 cm), hence excluding most patients undergoing resection for NC-HCC who have a large median tumour size. 11 As such, the BCLC recommendations for the management of HCC inappropriately limit liver resection to patients with early-stage tumours.…”

Section: Introductionmentioning

confidence: 99%

Development and validation of a risk score to predict the overall survival following surgical resection of hepatocellular carcinoma in non-cirrhotic liver

Dasari

Kamarajah

Hodson

et al. 2020

HPB

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Background: The aim of this study was to develop and validate a risk score to predict overall survival (OS) in patients undergoing surgical resection for hepatocellular carcinoma in non-cirrhotic liver (NC-HCC). Methods: Patients who underwent resection for NC-HCC between 2004 and 2013 were identified from the SEER database. A derivation set of 75% of this cohort was used to develop a risk score. This was then internally validated on the remaining patients, and externally validated using a cohort of patients from The HPB Unit, Birmingham, UK. Results: A total of 3897 patients were included from the SEER database, with a median post-diagnosis survival of 59 months. In the derivation set, multivariable analyses identified male sex, increasing tumour size, the presence of multiple tumours, bilobar tumours and major vascular invasion as adverse prognostic factors. A risk score generated from these factors was significantly predictive of OS, and was used to classify patients into low, medium and high-risk groups. These groups had a five-year OS of 69%, 51% and 19% in the internal, and 73%, 50% and 45% in the external validation sets. Conclusion: The proposed risk score is useful in the selection, pre-operative consenting and counselling of patients for surgery and to allow patients to make an informed decision regarding treatment.

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“…The last designation carries a poor prognosis because it is commonly associated with macroscopic vascular invasion, satellite nodules, and distant intra‐ or extrahepatic metastasis . Among the many currently employed classifications, the Barcelona Clinic Liver Cancer (BCLC) classification is the most reliable system for predicting outcomes, at least in patients with HCC in Western countries . This system is endorsed by the European Association for the Study of the Liver (EASL) and the American Association of the Study of Liver Disease (AASLD).…”

Section: Introductionmentioning

confidence: 99%

Hepatectomy for hepatocellular carcinoma larger than 10 cm: preoperative risk stratification to prevent futile surgery

Lim

Compagnon

Sebagh

et al. 2015

HPB

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Is there an ideal prognostic classification for hepatocellular carcinoma? The quest for the Holy Grail

Cited by 7 publications

References 22 publications

Evaluation of Midkine as a Diagnostic Serum Biomarker in Hepatocellular Carcinoma

Evaluation of Midkine as a Diagnostic Serum Biomarker in Hepatocellular Carcinoma

Development and validation of a risk score to predict the overall survival following surgical resection of hepatocellular carcinoma in non-cirrhotic liver

Hepatectomy for hepatocellular carcinoma larger than 10 cm: preoperative risk stratification to prevent futile surgery

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