Open AccessEvaluation of survival of patients with hepatocellular carcinoma: A comparative analysis of prognostic systems
Author(s) -
Roberta Kazan Tannus,
S. R. Almeida-Carvalho,
C. A. Loureiro-Matos,
Adriano M. Gonzalez,
Alcides Augusto Salzedas-Netto,
Dênis Szejnfeld,
Giuseppe D’Ippolito,
V. Pereira-Lanzoni,
I. Souza-Silva
Publication year - 2018
Publication title -
plos one
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.99
H-Index - 332
ISSN - 1932-6203
DOI - 10.1371/journal.pone.0194922
Subject(s) - akaike information criterion , medicine , hepatocellular carcinoma , liver cancer , tnm staging system , oncology , survival analysis , population , staging system , cancer , surgery , gastroenterology , statistics , mathematics , environmental health
Background and aim There are several prognostic systems that address different aspects of the patient and the tumour and can guide the management of patients with hepatocellular carcinoma (HCC). This study aimed to evaluate and compare the eight staging systems for a group of patients in a public service in Brazil. Methods Patients with HCC were retrospectively analysed between 2000 and 2012. The prognostic systems Okuda, The Cancer of the Liver Italian Program (CLIP), the Chinese University Prognostic Index (CUPI), Groupe d'Etude et de Traitément du Carcinome Hepatocellulaire (GRETCH), the modified TNM-based Japan Integrated Score (JIS) combined with alpha-fetoprotein and Child-Turcotte-Pugh (CTP), the TNM system, and the Barcelona Clinic Liver Cancer Classification (BCLC) were applied to these patients and compared through model fit measurements, likelihood scores, and the Akaike Information Criterion (AIC). Results A total of 247 patients were studied. The average survival time was 60 months. The TNM, Okuda, CLIP, GRETCH, modified JIS, and BCLC systems were well correlated with one another and individually important to the prediction of survival among the patients studied. However, in the statistical analysis, the CUPI delivered the best predictive performance (AIC = 566; log-likelihood = -281,240). Conclusion Although the CUPI system was demonstrated to be the most appropriate HCC staging system for the studied population, the choice of an ideal system is a controversial subject, and future studies with larger numbers of patients are necessary for the validation of the CUPI system as the method of choice for other populations.