Prognostic Value Of Different Staging Systems For Hepatocellular Carcinoma

ObjectiveTo evaluate the prognostic value of five staging systems for HCC (hepatocellularcarcinoma), including three clinical staging systems and two pathologic staging systems. The clinical staging systems evaluated were Okuda stage,CLIP (Cancer of The Liver Italian Program, CLIP) scoring system and the 4^th edition of LCSGJ (Liver Cancer Study Group of Japan, LCSGJ) TNM (tumor-node-metastasis, TNM) staging system. The pathologic staging systems compared were the 5th and 6th edition of UICC (International Union Against Cancer) /AJCC (American Joint Committee on Caner) TNM staging system.Materials and methodsClinicopathologic and follow-up data of 196 patients with curative resection of HCC from January 1995 to December 1999 were retrospectively studied. Univariate analysis of the prognostic significance of various clinicopathologic characteristics was performed using log rank test. Multivariate analysis was performed using Cox regression model. Linear trend chi-square test, likelihood ratio test and Harrel's concordant index were used to compare the homogeneity, discriminatory capacity, and monotonicity of gradients. AIC (Akaike information criterion, AIC) was also calculated to find the most efficient model.Results1, 3, and 5-year survival rates were 84.7%,64.1% and 34.9%, respectively, and median survival time was 41 months. Survival was significantly worse in those with symptoms at presentation, lower level of albumin, cirrhosis, portal hypertension, higher Child score, multiple tumors, higher AFP (Alpha-fetoprotein AFP) level, tumor...