Validation of prognostic accuracy of MESH, HKLC, and BCLC classifications in a large German cohort of hepatocellular carcinoma patients.
Adolescent
Adult
Aged
Aged, 80 and over
Antibodies, Monoclonal, Murine-Derived
Antineoplastic Combined Chemotherapy Protocols
Biomarkers, Tumor
/ blood
Biopsy
Carcinoma, Hepatocellular
/ diagnosis
Etoposide
Female
Germany
/ epidemiology
Humans
Ifosfamide
Kaplan-Meier Estimate
Liver
/ diagnostic imaging
Liver Neoplasms
/ blood
Magnetic Resonance Imaging
Male
Middle Aged
Mitoxantrone
Neoplasm Staging
/ methods
Predictive Value of Tests
Prognosis
ROC Curve
Retrospective Studies
Risk Assessment
/ methods
Tomography, X-Ray Computed
Young Adult
BCLC
HKLC
MESH
Staging
hepatocellular carcinoma
prognosis
survival
Journal
United European gastroenterology journal
ISSN: 2050-6414
Titre abrégé: United European Gastroenterol J
Pays: England
ID NLM: 101606807
Informations de publication
Date de publication:
05 2020
05 2020
Historique:
pubmed:
28
3
2020
medline:
29
6
2021
entrez:
28
3
2020
Statut:
ppublish
Résumé
The Barcelona Clinic Liver Cancer (BCLC) staging system is commonly used to classify hepatocellular carcinoma (HCC) patients. However, other staging classification schemes have been proposed. We aimed to compare the prognostic accuracy of the Hong Kong Liver Cancer Staging (HKLC), the Model to Estimate Survival for HCC (MESH), and the BCLC staging systems using a Western cohort of HCC patients. We retrospectively analyzed 918 patients diagnosed with HCC treated at the University Medical Center of Mainz between 2005 and 2014. We compared the predictive power of survival time of the BCLC, HKLC, and MESH. Predictive ability was tested using the integrated Brier score (IBS) and Harrell's C index. Kaplan-Meier analyses showed significant differences in survival between stages defined by the BCLC, HKLC, and MESH. The HKLC classification demonstrated a more robust classification concordance and lower prediction error compared to the BCLC and MESH. In addition, we found that the BCLC offers superior predictive ability to the MESH in the first four years, whereas the MESH is superior for long-term predictions. Our analyses confirm the prognostic value of three different HCC scoring systems. When compared, the HKLC provides superior prognostication ability.
Sections du résumé
BACKGROUND AND AIM
The Barcelona Clinic Liver Cancer (BCLC) staging system is commonly used to classify hepatocellular carcinoma (HCC) patients. However, other staging classification schemes have been proposed. We aimed to compare the prognostic accuracy of the Hong Kong Liver Cancer Staging (HKLC), the Model to Estimate Survival for HCC (MESH), and the BCLC staging systems using a Western cohort of HCC patients.
METHODS
We retrospectively analyzed 918 patients diagnosed with HCC treated at the University Medical Center of Mainz between 2005 and 2014. We compared the predictive power of survival time of the BCLC, HKLC, and MESH. Predictive ability was tested using the integrated Brier score (IBS) and Harrell's C index.
RESULTS
Kaplan-Meier analyses showed significant differences in survival between stages defined by the BCLC, HKLC, and MESH. The HKLC classification demonstrated a more robust classification concordance and lower prediction error compared to the BCLC and MESH. In addition, we found that the BCLC offers superior predictive ability to the MESH in the first four years, whereas the MESH is superior for long-term predictions.
CONCLUSION
Our analyses confirm the prognostic value of three different HCC scoring systems. When compared, the HKLC provides superior prognostication ability.
Identifiants
pubmed: 32213028
doi: 10.1177/2050640620904524
pmc: PMC7226688
doi:
Substances chimiques
Antibodies, Monoclonal, Murine-Derived
0
Biomarkers, Tumor
0
Etoposide
6PLQ3CP4P3
Mitoxantrone
BZ114NVM5P
Ifosfamide
UM20QQM95Y
Types de publication
Comparative Study
Journal Article
Research Support, Non-U.S. Gov't
Validation Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
444-452Références
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