[Prognostic prediction in patients with hepatocellular carcinoma not amenable to locoregional treatment].
OBJECTIVE
Patients with hepatocellular carcinoma (HCC) not amenable to locoregional therapy have some specific clinical characteristics (advanced cirrhosis or extrahepatic spread) that lead us to ascertain the prognostic efficacy of the different staging systems proposed for this entity.


METHODS
We analyze 100 patients (69 males) with a mean age of 70.2 (10.7) years. Tumor staging was performed at baseline according to the following systems: Okuda, Cancer of the Liver Italian Program (CLIP), Barcelona Clinic Liver Cancer (BCLC), and Japan Integrated Staging (JIS) score. We determine the area under the receiver operating characteristic curve (AUC) using the 6 and 12-month mortality as endpoint.


RESULTS
The BCLC system had the best predictive power for mortality both at 6 (AUC, 0.871) and 12 months (AUC, 0.924) from diagnosis. In the Cox multivariate analysis, this model showed an independent prognostic effect [hazard ratio: 9.14 for BCLC stage C versus A (p<0.001), and 9.53 for stage D versus A (p=0.004)].


CONCLUSIONS
The BCLC system provided the best prognostic stratification for patients with HCC not amenable to locoregional therapy.
Fernández-Ruiz
Mario
M
Servicio de Medicina Interna, Hospital Universitario 12 de Octubre, Universidad Complutense, Madrid, España. mario_fdezruiz@yahoo.es
Guerra-Vales
Juan Manuel
JM
Vila-Santos
Juan
J
Colina-Ruizdelgado
Francisco
F
D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000401:mortality* / Q000628:therapy; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000401:mortality* / Q000628:therapy; D008137:Longitudinal Studies; D008297:Male; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate; D017211:Treatment Failure