Prognostic accuracy of staging systems in patients with primary liver cancer undergoing transarterial chemoembolization

摘要

Background/Aims: To compare the performance of the Child-Turcotte-Pugh (CTP), the Okuda, the Cancer of Liver Italian Program (CLIP), the Barcelona Clinic Liver Cancer (BCLC), the Chinese staging (CS), Chinese university prognostic index (CUPI), Japan integrated staging (JIS), the Tokyo and the French staging systems, in predicting the survival of patients with primary liver cancer (PLC) receiving transarterial chemoembolization (TACE). Methodology: The clinical data of patients undergoing TACE in our department were retrospectively analyzed and compared with the 9 staging systems based on survival after TACE. Results: A cohort of 60 patients was involved. The survival curves showed that Okuda, BCLC, CS and JIS had better discriminatory ability. By the Cox regression model, Okuda, CS and JIS showed a stronger significance on prognosis. The staging systems with smaller value of -2Ln(L), Akaike Information criterion (AIC) and Schwarz-Bayesian criterion (SBC) were CS, JIS, CLIP and BCLC. An analysis involving 11 factors by Cox model indicated that ascites and vascular invasion were independent prognostic factors. Conclusions: JIS provides better prognostic stratification for a cohort of the patients with PLC receiving TACE. However, studies with larger samples are still required.