Heinrich Sophia, Sprinzl Martin, Schmidtmann Irene, Heil Elena, Koch Sandra, Czauderna Carolin, Heinrich Bernd, Philippe P Diggs Laurence, Wörns Marcus-Alexander, Kloeckner Roman, Galle Peter R, Marquardt Jens U, Weinmann Arndt
Department of Medicine I, University Medical Center, Mainz, Germany.
Thoracic and GI Malignancies Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, USA.
United European Gastroenterol J. 2020 May;8(4):444-452. doi: 10.1177/2050640620904524. Epub 2020 Jan 29.
The Barcelona Clinic Liver Cancer (BCLC) staging system is commonly used to classify hepatocellular carcinoma (HCC) patients. However, other staging classification schemes have been proposed. We aimed to compare the prognostic accuracy of the Hong Kong Liver Cancer Staging (HKLC), the Model to Estimate Survival for HCC (MESH), and the BCLC staging systems using a Western cohort of HCC patients.
We retrospectively analyzed 918 patients diagnosed with HCC treated at the University Medical Center of Mainz between 2005 and 2014. We compared the predictive power of survival time of the BCLC, HKLC, and MESH. Predictive ability was tested using the integrated Brier score (IBS) and Harrell's C index.
Kaplan-Meier analyses showed significant differences in survival between stages defined by the BCLC, HKLC, and MESH. The HKLC classification demonstrated a more robust classification concordance and lower prediction error compared to the BCLC and MESH. In addition, we found that the BCLC offers superior predictive ability to the MESH in the first four years, whereas the MESH is superior for long-term predictions.
Our analyses confirm the prognostic value of three different HCC scoring systems. When compared, the HKLC provides superior prognostication ability.
巴塞罗那临床肝癌（BCLC）分期系统常用于对肝细胞癌（HCC）患者进行分类。然而，也有人提出了其他分期分类方案。我们旨在使用西方HCC患者队列比较香港肝癌分期（HKLC）、肝癌生存预估模型（MESH）和BCLC分期系统的预后准确性。
我们回顾性分析了2005年至2014年间在美因茨大学医学中心接受治疗的918例诊断为HCC的患者。我们比较了BCLC、HKLC和MESH对生存时间的预测能力。使用综合Brier评分（IBS）和Harrell's C指数测试预测能力。
Kaplan-Meier分析显示，BCLC、HKLC和MESH定义的分期之间在生存方面存在显著差异。与BCLC和MESH相比，HKLC分类表现出更强的分类一致性和更低的预测误差。此外，我们发现BCLC在前四年的预测能力优于MESH，而MESH在长期预测方面更具优势。
我们的分析证实了三种不同HCC评分系统的预后价值。相比之下，HKLC具有更优的预后预测能力。
