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Review
. 2021 Apr 2;13(7):1673.
doi: 10.3390/cancers13071673.

Overview of Prognostic Systems for Hepatocellular Carcinoma and ITA.LI.CA External Validation of MESH and CNLC Classifications

Alessandro Vitale  1 , Fabio Farinati  1 , Michele Finotti  1 , Chiara Di Renzo  1 , Giuseppina Brancaccio  2 , Fabio Piscaglia  3   4 , Giuseppe Cabibbo  5 , Eugenio Caturelli  6 , Gabriele Missale  7 , Fabio Marra  8 , Rodolfo Sacco  9 , Edoardo G Giannini  10 , Franco Trevisani  11 , Umberto Cillo  1 , Associazione Italiana Per Lo Studio Del Fegato Aisf Hcc Special Interest Group  12 , Italian Liver Cancer Ita Li Ca Study Group  11
Affiliations
Review

Overview of Prognostic Systems for Hepatocellular Carcinoma and ITA.LI.CA External Validation of MESH and CNLC Classifications

Alessandro Vitale et al. Cancers (Basel). .

Abstract

Prognostic assessment in patients with HCC remains an extremely difficult clinical task due to the complexity of this cancer where tumour characteristics interact with degree of liver dysfunction, patient general health status, and a large span of available treatment options. Several prognostic systems have been proposed in the last three decades, both from the Asian and European/North American countries. Prognostic scores, such as the CLIP score and the recent MESH score, have been generated on a solid statistical basis from real life population data, while staging systems, such as the BCLC scheme and the recent CNLC classification, have been created by experts according to recent HCC prognostic evidences from the literature. A third category includes combined prognostic systems that can be used both as prognostic scores and staging systems. A recent example is the ITA.LI.CA prognostic system including either a prognostic score and a simplified staging system. This review focuses first on an overview of the main prognostic systems for HCC classified according to the above three categories, and, second, on a comprehensive description of the methodology required for a correct comparison between different systems in terms of prognostic performance. In this second section the main studies in the literature comparing different prognostic systems are described in detail. Lastly, a formal comparison between the last prognostic systems proposed for each of the above three categories is performed using a large Italian database including 6882 HCC patients in order to concretely apply the comparison rules previously described.

Keywords: discrimination ability; hepatocellular carcinoma; homogeneity; monotonicity of gradients; prognostic performance; prognostic system.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Hepatocellular carcinoma integrated prognostic systems proposed over time.
Figure 2
Figure 2
Kaplan-Meier survival curve of the study group stratified according to CLIP (A) and MESH (B) scores, BCLC (C) and CNLC (D) stages, ITA.LI.CA score (E) and ITA.LI.CA simplified staging (F). Log-rank test was always p < 0.001.
Figure 2
Figure 2
Kaplan-Meier survival curve of the study group stratified according to CLIP (A) and MESH (B) scores, BCLC (C) and CNLC (D) stages, ITA.LI.CA score (E) and ITA.LI.CA simplified staging (F). Log-rank test was always p < 0.001.
Figure 2
Figure 2
Kaplan-Meier survival curve of the study group stratified according to CLIP (A) and MESH (B) scores, BCLC (C) and CNLC (D) stages, ITA.LI.CA score (E) and ITA.LI.CA simplified staging (F). Log-rank test was always p < 0.001.
See this image and copyright information in PMC

References

    1. Amin M.B., Greene F.L., Edge S.B., Compton C.C., Gershenwald J.E., Brookland R.K., Meyer L., Gress D.M., Byrd D.R., Winchester D.P. The Eighth Edition AJCC Cancer Staging Manual: Continuing to Build a Bridge from a Population-Based to a More “Personalized” Approach to Cancer Staging. CA Cancer J. Clin. 2017;67:93–99. doi: 10.3322/caac.21388. - DOI - PubMed
    1. Bosetti C., Levi F., Boffetta P., Lucchini F., Negri E., La Vecchia C. Trends in Mortality from Hepatocellular Carcinoma in Europe, 1980–2004. Hepatology. 2008;48:137–145. doi: 10.1002/hep.22312. - DOI - PubMed
    1. Kamath P.S., Kim W.R. The Model for End-Stage Liver Disease (MELD) & Dagger. Hepatology. 2007;45:797–805. doi: 10.1002/hep.21563. - DOI - PubMed
    1. Pugh R.N.H., Murray-Lyon I.M., Dawson J.L., Pietroni M.C., Williams R. Transection of the Oesophagus for Bleeding Oesophageal Varices. BJS. 1973;60:646–649. doi: 10.1002/bjs.1800600817. - DOI - PubMed
    1. Johnson P.J., Berhane S., Kagebayashi C., Satomura S., Teng M., Reeves H.L., O’Beirne J., Fox R., Skowronska A., Palmer D., et al. Assessment of Liver Function in Patients with Hepatocellular Carci-Noma: A New Evidence-Based Approach—The ALBI Grade. J. Clin. Oncol. 2015;33:550–558. doi: 10.1200/JCO.2014.57.9151. - DOI - PMC - PubMed

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