Using nomogram of the Barcelona Clinic Liver Cancer system for treatment selection in patients with stage C hepatocellular carcinoma
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Authors
Hsu, Chia-Yang
Liu, Po-Hong
Ho, Shu-Yein
Hsia, Cheng-Yuan
Kudaravalli, Praneeth
Lee, Yun-Hsuan
Chiou, Yi-You
Tsai, Ya-Ju
Huang, Yi-Hsiang
Huo, Teh-Ia
Issue Date
2018
Type
Article
Language
Keywords
Barcelona clinic liver Cancer , Hepatocellular carcinoma , Nomogram , Staging system
Alternative Title
Abstract
The nomogram of the Barcelona Clinic Liver Cancer (BCLC) for hepatocellular carcinoma (HCC) has been used for outcome prediction. Patients with BCLC stage C HCC often undergo anti-cancer therapy against current treatment guidelines in real world practice. We aimed to use the nomogram to provide guidance on treatment selection for BCLC stage C patients. Methods: A total of 1317 patients with stage C HCC were retrospectively analyzed and divided into four groups by nomogram points. One-to-one matched pairs between patients receiving different treatments were generated by the propensity score with matching model within these groups. Survival analysis was performed by Kaplan-Meier method with log-rank test. Results: Patients with higher nomogram points were more often treated with targeted or supportive therapies (p < 0. 001). Patients receiving targeted or supportive therapies had a decreased survival compared to patients undergoing aggressive treatments (surgical resection, ablation, transarterial chemo-embolization or transplantation) across all four groups (p < 0.001). After matching for baseline differences in the propensity model, patients receiving different treatments had comparable age, gender, etiology of liver disease, tumor burden, severity of cirrhosis and performance status. Survival analyses were re-performed and disclosed that patients with nomogram points < 15 had better overall outcome after aggressive treatments (p < 0.05). For patients with nomogram points > 15, there was no significant difference in survival between patients receiving two different treatment strategies. Conclusions: The nomogram of BCLC system is a feasible tool to help stage C HCC patients to select primary anti-cancer treatment in pursuance of better overall survival.
Description
Citation
Hsu, C.-Y., Liu, P.-H., Ho, S.-Y., Hsia, C.-Y., Kudaravalli, P., Lee, Y.-H., … Huo, T.-I. (2018). Using nomogram of the Barcelona Clinic Liver Cancer system for treatment selection in patients with stage C hepatocellular carcinoma. BMC Cancer, 18(1). doi:10.1186/s12885-018-4202-3
Publisher
License
Creative Commons Attribution 4.0 International
Journal
Volume
Issue
PubMed ID
ISSN
1471-2407