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Prognostic value of the 7th edition of the AJCC staging system as a clinical staging system in patients with hepatocellular carcinoma.

 Yoon Hee Chun  ;  Seung Up Kim  ;  Jun Yong Park  ;  Do Young Kim  ;  Kwang-Hyub Han  ;  Chae Yoon Chon  ;  Beom Kyung Kim  ;  Gi Hong Choi  ;  Kyung Sik Kim  ;  Jin Sub Choi  ;  Sang Hoon Ahn 
 EUROPEAN JOURNAL OF CANCER, Vol.47(17) : 2568-2575, 2011 
Journal Title
Issue Date
Adult ; Aged ; Aged, 80 and over ; Carcinoma, Hepatocellular/mortality* ; Carcinoma, Hepatocellular/pathology* ; Carcinoma, Hepatocellular/surgery ; Female ; Humans ; Liver Neoplasms/mortality* ; Liver Neoplasms/pathology* ; Liver Neoplasms/surgery ; Male ; Middle Aged ; Neoplasm Staging/methods* ; Predictive Value of Tests ; Prognosis ; Proportional Hazards Models ; Retrospective Studies ; Survival Analysis ; Young Adult
AJCC staging ; BCLC staging ; Hepatocellular carcinoma ; Prognosis ; Survival ; TNM staging
BACKGROUND/AIMS: In 2009, the American Joint Committee on Cancer (AJCC) published the 7th edition of the hepatocellular carcinoma (HCC) staging system. We investigated the prognostic value of the 7th AJCC staging system as a clinical staging system in patients with HCC.

METHODS: We retrospectively applied the 6th and 7th AJCC systems to 877 patients who were diagnosed with HCC between January 2004 and December 2006 using radiological findings and compared the performance of the AJCC systems to that of the Barcelona Clinic Liver Cancer (BCLC) system. The prognostic power was quantified using a linear trend χ(2) test and -2 log likelihood.

RESULTS: The median age was 57years and males predominated (n=701, 79.9%). There was no significant difference in survival between adjoining advanced stages of the 6th and 7th AJCC systems (⩾stage IIIA in the 6th and ⩾stage IIIB in the 7th; all p>0.05), although a significant difference between adjoining early stages was identified. The 7th AJCC system had greater prognostic power than the 6th (linear trend χ(2) test, 168.195 versus 160.293; -2 log likelihood, 7366.347 versus 7396.380), but not greater than that of the BCLC system (linear trend χ(2) test=207.013, -2 log likelihood=7320.726).

CONCLUSIONS: The 7th AJCC staging system provided better prognostic power than the 6th for patients with HCC, but not better than that of the BCLC system. Thus, the 7th AJCC staging system should be applied cautiously in patients with advanced HCC because of its low prognostic power in advanced stages.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Kyung Sik(김경식) ORCID logo https://orcid.org/0000-0001-9498-284X
Kim, Do Young(김도영)
Kim, Beom Kyung(김범경) ORCID logo https://orcid.org/0000-0002-5363-2496
Kim, Seung Up(김승업) ORCID logo https://orcid.org/0000-0002-9658-8050
Park, Jun Yong(박준용) ORCID logo https://orcid.org/0000-0001-6324-2224
Ahn, Sang Hoon(안상훈) ORCID logo https://orcid.org/0000-0002-3629-4624
Chon, Chae Yoon(전재윤)
Chun, Yoon Hee(천윤희)
Choi, Gi Hong(최기홍) ORCID logo https://orcid.org/0000-0002-1593-3773
Choi, Jin Sub(최진섭)
Han, Kwang-Hyub(한광협) ORCID logo https://orcid.org/0000-0003-3960-6539
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