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Comparative Study
. 2017 Apr 14;23(14):2545-2555.
doi: 10.3748/wjg.v23.i14.2545.

Barcelona clinic liver cancer nomogram and others staging/scoring systems in a French hepatocellular carcinoma cohort

Xavier Adhoute  1 , Guillaume Pénaranda  1 , Jean Luc Raoul  1 , Julien Edeline  1 , Jean-Frédéric Blanc  1 , Bernard Pol  1 , Manuela Campanile  1 , Hervé Perrier  1 , Olivier Bayle  1 , Olivier Monnet  1 , Patrick Beaurain  1 , Cyril Muller  1 , Paul Castellani  1 , Yves Patrice Le Treut  1 , Jean Pierre Bronowicki  1 , Marc Bourlière  1
Affiliations
Comparative Study

Barcelona clinic liver cancer nomogram and others staging/scoring systems in a French hepatocellular carcinoma cohort

Xavier Adhoute et al. World J Gastroenterol. .

Abstract

Aim: To compare the performances of the Barcelona clinic liver cancer (BCLC) nomogram and others systems (BCLC, HKLC, CLIP, NIACE) for survival prediction in a large hepatocellular carcinoma (HCC) French cohort.

Methods: Data were collected retrospectively from 01/2007 to 12/2013 in five French centers. Newly diagnosed HCC patients were analyzed. The discriminatory ability, homogeneity ability, prognostic stratification ability Akaike information criterion (AIC) and C-index were compared among scoring systems.

Results: The cohort included 1102 patients, mostly men, median age 68 [60-74] years with cirrhosis (81%), child-Pugh A (73%), alcohol-related (41%), HCV-related (27%). HCC were multinodular (59%) and vascular invasion was present in 41% of cases. At time of HCC diagnosis BCLC stages were A (17%), B (16%), C (60%) and D (7%). First line HCC treatment was curative in 23.5%, palliative in 59.5%, BSC in 17% of our population. Median OS was 10.8 mo [4.9-28.0]. Each system distinguished different survival prognosis groups (P < 0.0001). The nomogram had the highest discriminatory ability, the highest C-index value. NIACE score had the lowest AIC value. The nomogram distinguished sixteen different prognosis groups. By classifying unifocal large HCC into tumor burden 1, the nomogram was less powerful.

Conclusion: In this French cohort, the BCLC nomogram and the NIACE score provided the best prognostic information, but the NIACE could even help treatment strategies.

Keywords: Barcelona clinical liver cancer; CLIP; Hepatocellular carcinoma; Hong kong liver cancer; NIACE.

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Conflict of interest statement

Conflict-of-interest statement: No potential conflicts of interest relevant to this article were reported.

Figures

Figure 1
Figure 1
Flow diagram shows the patient selection criteria. BCLC: Barcelona Clinic Liver Cancer; HCC: Hepatocellular carcinoma; PS: Performance status; TACE: Trans arterial chemoembolization.
Figure 2
Figure 2
Kaplan-Meier estimated survival curves stratified according to Barcelona clinic liver cancer stages (A) or to Barcelona clinic liver cancer nomogram stratified in 5 classes (0-5), (5-10), (10-15), (15-19), (≥ 20) (B).
Figure 3
Figure 3
Overall survival Histograms according to HKLC staging system, CLIP score and NIACE score in our hepatocellular carcinoma cohort.
Figure 4
Figure 4
Survival time in months according to hepatocellular carcinoma nomogram. Hsu et al[27] in our hepatocellular carcinoma cohort.
See this image and copyright information in PMC

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