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 wer...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.展开更多
Background and Aims:Hepatocellular carcinoma(HCC)and intrahepatic cholangiocarcinoma(iCCA)have common features and differences.This real-life study investigated their characteristics,treatment modalities,and prognoses...Background and Aims:Hepatocellular carcinoma(HCC)and intrahepatic cholangiocarcinoma(iCCA)have common features and differences.This real-life study investigated their characteristics,treatment modalities,and prognoses.Methods:This retrospective comparative study was performed in 1,075 patients seen at one tertiary center between January 2008 and December 2020.Overall survival(OS)was estimated by the Kaplan-Meier method.Subclassification of iCCAs after histological and radiological review,and molecular profiling was performed.Results:HCCs patients were more likely to have early-stage disease than iCCA patients.iCCA patients were more likely to be female,especially those patients without cirrhosis(43%vs.17%).Cirrhosis was prominent among HCC patients(89%vs.34%),but no difference in underlying liver disease among cirrhotic patients was found.OS of HCC patients was 18.4(95%CI:6.4,48.3)months,that of iCCA patients was 7.0(95%CI:3.4,20.1)months.OS of Barcelona Clinic Liver Cancer C HCC patients was 7.8(95%CI:4.3,14.2)months,that of advanced/metastatic iCCA patients was 8.5(95%CI:5.7,12.3)months.In patients treated with sorafenib,OS was longer in HCC patients who received subsequent tyrosine kinase inhibitor therapies.No significant OS difference was found between iCCA patients with and without cirrhosis or according to histological subtype.A targetable molecular alteration was detected in 50%of the iCCA patients.Conclusions:In this French series,cirrhosis was common in iCCA,which showed etiological factors comparable to those of HCC,implying a distinct oncogenic pathway.Both entities had a dismal prognosis at advanced stages.However,systemic therapies sequencing in HCC and molecular profiling in iCCA offer new insights.展开更多
文摘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.
文摘Background and Aims:Hepatocellular carcinoma(HCC)and intrahepatic cholangiocarcinoma(iCCA)have common features and differences.This real-life study investigated their characteristics,treatment modalities,and prognoses.Methods:This retrospective comparative study was performed in 1,075 patients seen at one tertiary center between January 2008 and December 2020.Overall survival(OS)was estimated by the Kaplan-Meier method.Subclassification of iCCAs after histological and radiological review,and molecular profiling was performed.Results:HCCs patients were more likely to have early-stage disease than iCCA patients.iCCA patients were more likely to be female,especially those patients without cirrhosis(43%vs.17%).Cirrhosis was prominent among HCC patients(89%vs.34%),but no difference in underlying liver disease among cirrhotic patients was found.OS of HCC patients was 18.4(95%CI:6.4,48.3)months,that of iCCA patients was 7.0(95%CI:3.4,20.1)months.OS of Barcelona Clinic Liver Cancer C HCC patients was 7.8(95%CI:4.3,14.2)months,that of advanced/metastatic iCCA patients was 8.5(95%CI:5.7,12.3)months.In patients treated with sorafenib,OS was longer in HCC patients who received subsequent tyrosine kinase inhibitor therapies.No significant OS difference was found between iCCA patients with and without cirrhosis or according to histological subtype.A targetable molecular alteration was detected in 50%of the iCCA patients.Conclusions:In this French series,cirrhosis was common in iCCA,which showed etiological factors comparable to those of HCC,implying a distinct oncogenic pathway.Both entities had a dismal prognosis at advanced stages.However,systemic therapies sequencing in HCC and molecular profiling in iCCA offer new insights.
