Brief Article
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World J Gastroenterol. Nov 7, 2010; 16(41): 5257-5262
Published online Nov 7, 2010. doi: 10.3748/wjg.v16.i41.5257
Staging systems for predicting survival of patients with hepatocellular carcinoma after surgery
Lei-Bo Xu, Jie Wang, Chao Liu, Hao-Wei Pang, Ya-Jin Chen, Qing-Jia Ou, Ji-Sheng Chen
Lei-Bo Xu, Jie Wang, Chao Liu, Ya-Jin Chen, Qing-Jia Ou, Ji-Sheng Chen, Department of Hepato-Pancreato-Biliary Surgery, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou 510120, Guangdong Province, China
Hao-Wei Pang, Department of Emergency, Huangpu Branch, First Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510080, Guangdong Province, China
Author contributions: Xu LB and Wang J contributed equally to this paper and wrote the manuscript; Liu C designed the study; Pang HW, Xu LB and Wang J collected the data; Chen YJ and Chen JS analyzed and interpreted the data; Ou QJ approved the submission.
Supported by Special Research Foundation of National Nature Science Foundation of China, No. 30872487
Correspondence to: Chao Liu, MD, Professor, Department of Hepato-Pancreato-Biliary Surgery, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou 510120, Guangdong Province, China. mdliuchao@hotmail.com
Telephone: +86-20-34071172 Fax: +86-20-83755229
Received: June 19, 2010
Revised: August 2, 2010
Accepted: August 9, 2010
Published online: November 7, 2010
Abstract

AIM: To compare the staging systems for stratifying and predicting the prognosis of patients with hepatocellular carcinoma (HCC) after partial hepatectomy (PH).

METHODS: Clinical data about 438 HCC patients who underwent PH from January 1991 to December 2004 at our hospital were retrospectively analyzed. Tumor stage was evaluated following the Chinese tumor node metastasis (TNM) and barcelona clinic liver cancer (BCLC) staging systems, respectively. Survival curves for the HCC patients were plotted using the Kaplan-Meier method and differences were compared by the log-rank test. The accuracy of each system for predicting death of HCC patients was evaluated by calculating the area under the receiver operating characteristic curve.

RESULTS: The HCC patients were classified into stages I-III, stages I-IV and stages A-C, according to the 3 staging systems, respectively. Log-rank test showed that the cumulative survival rate was significantly different for the HCC patients at 3 Chinese system stages, TNM stages I and II, TNM stages III and IV, and 3 BCLC stages (P < 0.05). However, no significant difference was found in the HCC patients at TNM stages II and III. The accuracy of the Chinese and BCLC staging systems was higher than that of the TNM staging system for predicting the survival rate of HCC patients.

CONCLUSION: The Chinese and BCLC staging systems are better for stratifying and predicting the prognosis of HCC patients after PH than the TNM staging system.

Keywords: Hepatocellular carcinoma; Tumor staging; Prognosis; Survival; Hepatectomy