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A new substage classification strategy for Barcelona Clinic Liver Cancer stage B patients with hepatocellular carcinoma
Author(s) -
Hu KeShu,
Tang Bei,
Yuan Jia,
Lu ShenXin,
Li Miao,
Chen RongXin,
Zhang Lan,
Ren ZhengGang,
Yin Xin
Publication year - 2019
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/jgh.14673
Subject(s) - medicine , hepatocellular carcinoma , stage (stratigraphy) , hazard ratio , liver cancer , confidence interval , cancer , population , carcinoma , multivariate analysis , oncology , gastroenterology , paleontology , environmental health , biology
Background and Aim Patients with Barcelona Clinic Liver Cancer stage B hepatocellular carcinoma are a heterogeneous population, and the classifications available could not predict the prognosis accurately. Herein, we proposed a new substage classification method, Scoring Method for Intermediate Stage, for precise classification and clinical guidance in hepatocellular carcinoma patients within Barcelona Clinic Liver Cancer stage B. Methods A total of 1026 stage B patients of hepatocellular carcinoma who underwent transcatheter arterial chemoembolization as a first‐line treatment in Liver Cancer Institute, Zhongshan Hospital, Fudan University were retrospectively enrolled. The prognostic evaluation ability of the new substage classification criteria was analyzed, in comparison with the existing substage classification criteria. Results Using Scoring Method for Intermediate Stage, 1026 stage B patients were subclassified into three subgroups, based on Child–Pugh score and up‐to‐7 grade, as B1 (scoring 2), B2 (scoring 3 or 4), and B3 (scoring 5 or 6). The median survival time of the three substages was 29 (95% confidence interval [CI]: 25–36), 19 (95% CI: 16–21), and 10 (95% CI: 8–12) months, respectively. More favorable discrimination efficacy was identified by the new criteria in comparison with the existing substage classification criteria, including Bolondi, Kinki, MICAN, and Kim's criteria. Moreover, multivariate analyses indicated that the novel classification was highly associated with prognosis (Hazard ratio(s) = 1.63, 95% CI: 1.43–1.86, P < 0.001). Conclusions Scoring Method for Intermediate Stage demonstrates satisfying capacity in classifying patients with stage B hepatocellular carcinoma and predicting prognosis.