Simplified Staging for Hepatocellular Carcinoma

• DOI: 10.1200/jco.2002.20.6.1527
• Publication Date: 2017-02-24T08:46:10Z
• Authors: Jean-Nicolas Vauthey; Gregory Y. Lauwers; Nestor F. Esnaola; Kim-Anh Do; Jacques Belghiti; Nadeem Mirza; Steven A. Curley; Lee M. Ellis; Jean-Marc Regimbeau; Asif Rashid; Karen R. Cleary; David M. Nagorney
• Keywords: Vascular invasion

PURPOSE: The current American Joint Committee on Cancer (AJCC) staging system for hepatocellular carcinoma (HCC) fails to stratify patients adequately with respect prognosis. PATIENTS AND METHODS: ability of the currently proposed tumor (T) categories effectively survival 557 who underwent complete resection HCC at four centers was examined. Independent predictors were combined into a new system. RESULTS: Using AJCC T classification, T1 and T2 tumors had similar 5-year survivals (P = .6). In addition, multiple bilobar (T4) matched that T3 .5). death major vascular invasion < .001), microvascular severe fibrosis/cirrhosis host liver .007), size greater than 5 cm .01). Based our results, simplified stratification is proposed: (a) single no invasion, (b) or tumors, none more cm, (c) either any .001). Severe negative impact within all categories. lymph node involvement .3). CONCLUSION: unnecessarily complex. We propose model based number, incorporates effect fibrosis survival.