title: Selection of treatment modality for hepatocellular carcinoma according to the modified Japan Integrated Staging score.
abstract: OBJECTIVE
  To compare the prognosis of patients who underwent hepatectomy and ablation using the modified Japan Integrated Staging score (mJIS).
  
  
  METHODS
  We examined the clinicopathologic records and patient outcomes in 278 HCC patients including 226 undergoing hepatectomy and 52 undergoing ablation therapy.
  
  
  RESULTS
  Cirrhosis was more frequent in the ablation group. Tumor size, number and presence of vascular invasion were significantly higher in the operation group compared to the ablation group. The local recurrence rate adjacent to treated lesions was significantly higher in the ablation group compared to the operation group (P < 0.05). The 3- and 5-year survival rates in the ablation and the operation group were 66% and 78%, and 50% and 63%, respectively, but not significantly different. Over 50% survival rates were observed in patients with a mJIS score of 0-2 in both groups. However, survival rates with a score of 3-5 in both groups were significantly lower.
  
  
  CONCLUSIONS
  According to the mJIS system, both local treatments could be selected for patients with a score of 0-2. However, for patients with a score more than 3, liver transplantation might be a better option in patients with HCC.
authors.affiliation: Division of Surgical Oncology, Department of Translational Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki 852-8501, Japan. a-nanasm@alpha.med.nagasaki-u.ac.jp
authors.forename: Atsushi
authors.initials: A
authors.lastname: Nanashima
authors.forename: Junichi
authors.initials: J
authors.lastname: Masuda
authors.forename: Satoshi
authors.initials: S
authors.lastname: Miuma
authors.forename: Yorihisa
authors.initials: Y
authors.lastname: Sumida
authors.forename: Takashi
authors.initials: T
authors.lastname: Nonaka
authors.forename: Kenji
authors.initials: K
authors.lastname: Tanaka
authors.forename: Shigekazu
authors.initials: S
authors.lastname: Hidaka
authors.forename: Terumitsu
authors.initials: T
authors.lastname: Sawai
authors.forename: Takeshi
authors.initials: T
authors.lastname: Nagayasu
mesh_terms: D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D005260:Female; D006498:Hepatectomy; D006801:Humans; D007564:Japan; D008113:Liver Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D009367:Neoplasm Staging / Q000379:methods*