Proposal of the performance status combined Japan Integrated Staging system in hepatocellular carcinoma complicated with cirrhosis

  • Authors:
    • Hiroki Nishikawa
    • Ryuichi Kita
    • Toru Kimura
    • Masatsugu Endo
    • Yoshiaki Ohara
    • Azusa Sakamoto
    • Sumio Saito
    • Norihiro Nishijima
    • Akihiro Nasu
    • Hideyuki Komekado
    • Yukio Osaki
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  • Published online on: April 17, 2015     https://doi.org/10.3892/ijo.2015.2969
  • Pages: 2371-2379
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Abstract

The present study examined the prognostic ability of our proposed performance status combined Japan Integrated Staging (PS-JIS) system in hepatocellular carcinoma (HCC) patients with liver cirrhosis (LC) comparing with other four prognostic systems including original JIS system, the Barcelona Clinic Liver Cancer classification system, TNM classification system and the Cancer of the Liver Italian Program (CLIP) scoring system. A total of 1,170 HCC patients complicated with LC were analysed. The disease was staged for all analysed patients by means of the five staging systems. The cumulative overall survival (OS) rate was calculated by Kaplan-Meier method and tested by log-rank test. We also examined prognostic factors associated with OS using univariate and multivariate analyses and compared the prognostic ability in each prognostic system using concordance index (c-index) at 1-, 3- and 5-year time-points. Overall significance in each prognostic system was P<0.001. In the multivariate analyses, tumor number, Child-Pugh classification, PS, initial treatment modality and several laboratory parameters were significant independent predictors linked to OS. For all cases, in each time-point, the c-index of PS-JIS system was the highest among five staging systems (0.847, 0.816 and 0.808, respectively), indicating that PS-JIS system has the best predictability among these staging systems. According to subgroup analyses stratified by initial treatment modality, in patients treated with surgical resection (n=205), CLIP scoring system had the highest c-index at every time-point, whereas in patients treated with percutaneous ablative therapies (n=632) at 3- and 5-year time-point and in those with transcatheter arterial therapies (n=281) at every time-point, the c-index of PS-JIS system was the highest. In conclusion, the proposed PS-JIS score can be a useful prognostic system for HCC patients complicated with liver cirrhosis.
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June-2015
Volume 46 Issue 6

Print ISSN: 1019-6439
Online ISSN:1791-2423

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Spandidos Publications style
Nishikawa H, Kita R, Kimura T, Endo M, Ohara Y, Sakamoto A, Saito S, Nishijima N, Nasu A, Komekado H, Komekado H, et al: Proposal of the performance status combined Japan Integrated Staging system in hepatocellular carcinoma complicated with cirrhosis. Int J Oncol 46: 2371-2379, 2015
APA
Nishikawa, H., Kita, R., Kimura, T., Endo, M., Ohara, Y., Sakamoto, A. ... Osaki, Y. (2015). Proposal of the performance status combined Japan Integrated Staging system in hepatocellular carcinoma complicated with cirrhosis. International Journal of Oncology, 46, 2371-2379. https://doi.org/10.3892/ijo.2015.2969
MLA
Nishikawa, H., Kita, R., Kimura, T., Endo, M., Ohara, Y., Sakamoto, A., Saito, S., Nishijima, N., Nasu, A., Komekado, H., Osaki, Y."Proposal of the performance status combined Japan Integrated Staging system in hepatocellular carcinoma complicated with cirrhosis". International Journal of Oncology 46.6 (2015): 2371-2379.
Chicago
Nishikawa, H., Kita, R., Kimura, T., Endo, M., Ohara, Y., Sakamoto, A., Saito, S., Nishijima, N., Nasu, A., Komekado, H., Osaki, Y."Proposal of the performance status combined Japan Integrated Staging system in hepatocellular carcinoma complicated with cirrhosis". International Journal of Oncology 46, no. 6 (2015): 2371-2379. https://doi.org/10.3892/ijo.2015.2969