Comparison of three current staging systems for hepatocellular carcinoma: Japan integrated staging score, new Barcelona Clinic Liver Cancer staging classification, and Tokyo score.
OBJECTIVE
Although various staging systems for hepatocellular carcinoma (HCC) have been developed in recent years, there is no worldwide consensus which staging system is best. The aim of the present study was to compare the performance of the currently developed three staging systems: the Japan integrated staging (JIS) score, new Barcelona Clinic Liver Cancer (BCLC) staging classification, and the Tokyo score.


METHODS
A total of 290 consecutive patients with HCC before initial treatment at Kinki University between January 1999 and December 2001 were included. The patients were stratified according to the three staging systems, and the performance of the staging systems was compared using survival time as the only outcome measure.


RESULTS
There were significant differences between all stages in the JIS score, while no significant difference was found between stages C and D in the BCLC staging classification and between all the scores, except between scores 0 and 1 and 2 and 3 in the Tokyo score. For all patients (n = 290), the radical treatment group (n = 208) and the non-radical treatment group (n = 82), the likelihood ratio chi(2)-test showed the highest value, and the Akaike information criterion value was lowest in the JIS score.


CONCLUSIONS
The JIS score provided the best prognostic stratification in a Japanese cohort of HCC patients who were mainly diagnosed at early stages and treated with radical therapies.
Department of Gastroenterology, Kinki University School of Medicine, Osaka-Sayama, Japan.
Hobyung
H
Chung
Masatoshi
M
Kudo
Shunsuke
S
Takahashi
Satoru
S
Hagiwara
Yasuhiro
Y
Sakaguchi
Tatsuo
T
Inoue
Yasunori
Y
Minami
Kazuomi
K
Ueshima
Toyokazu
T
Fukunaga
Takashi
T
Matsunaga
D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000145:classification / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D005260:Female; D006801:Humans; D007564:Japan; D053208:Kaplan-Meier Estimate; D016013:Likelihood Functions; D008113:Liver Neoplasms / Q000145:classification / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D008297:Male; D009367:Neoplasm Staging; D018579:Patient Selection; D011379:Prognosis; D016016:Proportional Hazards Models; D015203:Reproducibility of Results