改良分期系统（近畿标准）对中期肝细胞癌患者的验证

Validation of a Modified Substaging System (Kinki Criteria) for Patients with Intermediate-Stage Hepatocellular Carcinoma.

作者信息

Arizumi Tadaaki, Ueshima Kazuomi, Iwanishi Mina, Minami Tomohiro, Chishina Hirokazu, Kono Masashi, Takita Masahiro, Kitai Satoshi, Inoue Tatsuo, Yada Norihisa, Hagiwara Satoru, Ida Hiroshi, Minami Yasunori, Sakurai Toshiharu, Kitano Masayuki, Nishida Naoshi, Kudo Masatoshi

机构信息

Department of Gastroenterology and Hepatology, Faculty of Medicine, Kinki University, Osaka-Sayama, Japan.

出版信息

Oncology. 2015;89 Suppl 2:47-52. doi: 10.1159/000440631. Epub 2015 Nov 19.

DOI:10.1159/000440631

PMID:26584036

Abstract

INTRODUCTION

Barcelona Clinic Liver Cancer (BCLC) stage B, an intermediate stage, includes various conditions of hepatocellular carcinoma (HCC). This heterogeneity of the patients with intermediate-stage HCC makes it difficult to predict their survival rates. In the present study, we examined the validity of the modified Bolondi classification (Kinki criteria) as a subclassification of patients with BCLC stage B HCC.

METHODS

Of 906 patients who underwent conventional transarterial chemoembolization at Kinki University Hospital, 753, who met the inclusion criteria, were examined. Of these 753 patients, 425 (56.4%) with BCLC stage B were subclassified using the Kinki criteria to examine the survival rate.

RESULTS

According to the Kinki criteria, 158 (37.2%) were subclassified into subclass B1, 236 (55.5%) into B2, and 31 (7.3%) into B3. The comparison of the survival rates showed that the median overall survival was 3.9 years (95% CI, 3.2-4.6) in the BCLC subclass B1 group, 2.5 years (95% CI, 2.2-3.1) in the B2 group, and 1.1 years (95% CI, 0.6-1.5) in the B3 group (p < 0.001).

CONCLUSION

When the BCLC stage B patients were subclassified according to the Kinki criteria, survival curves were stratified with significant differences, suggesting that the Kinki criteria were suitable for the subclassification of the intermediate-stage HCC patients.

摘要

引言

巴塞罗那临床肝癌（BCLC）分期中的B期为中期，包括各种肝细胞癌（HCC）情况。中期HCC患者的这种异质性使得预测其生存率变得困难。在本研究中，我们检验了改良的博隆迪分类法（近畿标准）作为BCLC B期HCC患者亚分类方法的有效性。

方法

在近畿大学医院接受传统经动脉化疗栓塞术的906例患者中，对符合纳入标准的753例患者进行了研究。在这753例患者中，425例（56.4%）为BCLC B期，采用近畿标准进行亚分类以检验生存率。

结果

根据近畿标准，158例（37.2%）被亚分类为B1亚类，236例（55.5%）为B2亚类，31例（7.3%）为B3亚类。生存率比较显示，BCLC B1亚类组的中位总生存期为3.9年（95%CI，3.2 - 4.6），B2亚类组为2.5年（95%CI，2.2 - 3.1），B3亚类组为1.1年（95%CI，0.6 - 1.5）（p < 0.001）。