Published online May 28, 2017. doi: 10.4254/wjh.v9.i15.711
Peer-review started: February 9, 2017
First decision: March 6, 2017
Revised: March 15, 2017
Accepted: April 23, 2017
Article in press: April 24, 2017
Published online: May 28, 2017
The Barcelona Clinic Liver Cancer classification is the most widely - used hepatocellular carcinoma (HCC) staging system because it is simple, precise and linked to a treatment algorithm based on randomized studies. But each group includes a broad spectrum of tumors, with limited therapeutic options, particularly for intermediate and advanced stages. Consequently, different additional scoring systems have been proposed to refine the prognosis and/or to improve the management. But until now, there is no consensus. Liu et al proposes a new scoring system, based on a large HCC cohort, with patients at different stages, treated using diverse modalities. This score includes six parameters used in current practice. It is simple to calculate, reliable, with an ability to predict survival superior to other systems, which also works with our European HCC cohort. The MESH score may be especially useful to differentiate subgroups with different prognosis for each treatment modality.
Core tip: The Barcelona Clinic Liver Cancer system has become the reference classification for hepatocellular carcinoma (HCC). But it has been criticized; each group includes a broad spectrum of tumors with limited therapeutic options. For this reason, different additional scoring systems have been proposed to improve the management. Liu et al proposes the MESH score, based on a large HCC cohort. It includes six parameters used in current practice, and in a European HCC cohort, this new score appears to be simple, reliable and useful to differentiate subgroups with different prognosis for each treatment modality.