巴塞罗那临床肝癌分期系统的前瞻性验证

Prospective validation of the Barcelona Clinic Liver Cancer staging system.

作者信息

Cillo Umberto, Vitale Alessandro, Grigoletto Francesco, Farinati Fabio, Brolese Alberto, Zanus Giacomo, Neri Daniele, Boccagni Patrizia, Srsen Nela, D'Amico Francesco, Ciarleglio Francesco Antonio, Bridda Alessio, D'Amico Davide Francesco

机构信息

Clinica Chirurgica I, Dipartimento di Scienze Chirurgiche e Gastroenterologiche, School of Medicine, University of Padua, Via Giustiniani 2, Policlinico III Piano, 35128 Padova, Italy.

出版信息

J Hepatol. 2006 Apr;44(4):723-31. doi: 10.1016/j.jhep.2005.12.015. Epub 2006 Jan 24.

DOI:10.1016/j.jhep.2005.12.015

PMID:16488051

Abstract

BACKGROUND/AIMS: The Barcelona Clinic Liver Cancer (BCLC) classification offers a prognostic stratification of patients with hepatocellular carcinoma (HCC). We recently demonstrated the BCLC's peculiar prognostic ability in a retrospective cohort of HCC patients. The aim of this study was to evaluate the BCLC system prospectively in a subsequent separate group of HCC patients enrolled at the same surgically oriented liver unit.

METHODS

One hundred and ninety-five consecutive HCC patients were prospectively enrolled and their liver disease was staged before therapy. Unlike the BCLC treatment protocol, nodule size and number were not used as absolute exclusion criteria for radical treatment. Predictors of survival were identified using the Cox model.

RESULTS

The median survival time was 23 months overall, and 53, 16, 7 and 3 months, respectively, for BCLC categories A, B, C, and D. In our cohort, BCLC had the best independent predictive power for survival when compared with the Okuda, CLIP, UNOS-TNM, and JIS prognostic systems (linear trend chi(2)=43.01, likelihood chi(2)=57.94, AIC 885.98). Moreover, the BCLC classification showed a better prognostic ability than the AJCC-TNM 2002 system in surgical patients.

CONCLUSIONS

The discriminating power of BCLC staging was prospectively assessed in an Italian cohort of HCC patients treated mainly with radical therapies.

摘要

背景/目的：巴塞罗那临床肝癌（BCLC）分类法为肝细胞癌（HCC）患者提供了预后分层。我们最近在一组HCC患者回顾性队列中证实了BCLC独特的预后能力。本研究的目的是在同一以手术为主的肝病治疗中心纳入的另一组独立HCC患者中对BCLC系统进行前瞻性评估。

方法

前瞻性纳入195例连续的HCC患者，并在治疗前对其肝病进行分期。与BCLC治疗方案不同，结节大小和数量未被用作根治性治疗的绝对排除标准。使用Cox模型确定生存预测因素。

结果

总体中位生存时间为23个月，BCLC A、B、C和D期患者的中位生存时间分别为53、16、7和3个月。在我们的队列中，与奥田、CLIP、UNOS-TNM和JIS预后系统相比，BCLC对生存具有最佳的独立预测能力（线性趋势卡方=43.01，似然卡方=57.94，AIC 885.98）。此外，在手术患者中，BCLC分类法显示出比AJCC-TNM 2002系统更好的预后能力。