Evidence map›Paper›PMID 34008091›Full record

ArticleHepatology international2021

Resubclassification and clinical management for Barcelona Clinic Liver Cancer Stage C hepatocellular carcinoma.

Chih-Wen Lin, Yaw-Sen Chen, Gin-Ho Lo, Tsung-Chin Wu, Jen-Hao Yeh, Ming-Lun Yeh, Chia-Yen Dai, Jee-Fu Huang, Wan-Long Chuang, Lewis Roberts and 5 more

Abstract read
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In one paragraph

Article in Hepatology international, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.

0numbers the graph read from it
0cells of the map it votes in
12citing papers in PubMed
1.5field-weighted citation impact, top 16% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

12 citing papers in PubMed, 17 citations in OpenAlex.

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  12. Prognosis prediction or treatment allocation?Hepatology international · 2021
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors at 8 institutions in 4 countries.

Chih-Wen LinDivision of Gastroenterology and Hepatology, E-Da Dachang Hospital, I-Shou University, Kaohsiung, Taiwan.
Yaw-Sen ChenDepartment of Surgery, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan.
Gin-Ho LoDivision of Gastroenterology and Hepatology, E-Da Dachang Hospital, I-Shou University, Kaohsiung, Taiwan.
Tsung-Chin WuDivision of Gastroenterology and Hepatology, E-Da Dachang Hospital, I-Shou University, Kaohsiung, Taiwan.
Jen-Hao YehDivision of Gastroenterology and Hepatology, E-Da Dachang Hospital, I-Shou University, Kaohsiung, Taiwan.
Ming-Lun YehHepatobiliary Division, Department of Internal Medicine, and Hepatitis Center, Kaohsiung Medical University Hospital, School of Medicine, College of Medicine, Kaohsiung Medical University, No. 100, Tzyou 1st Road, Kaohsiung, 807, Taiwan.
Chia-Yen DaiHepatobiliary Division, Department of Internal Medicine, and Hepatitis Center, Kaohsiung Medical University Hospital, School of Medicine, College of Medicine, Kaohsiung Medical University, No. 100, Tzyou 1st Road, Kaohsiung, 807, Taiwan.
Jee-Fu HuangHepatobiliary Division, Department of Internal Medicine, and Hepatitis Center, Kaohsiung Medical University Hospital, School of Medicine, College of Medicine, Kaohsiung Medical University, No. 100, Tzyou 1st Road, Kaohsiung, 807, Taiwan.
Wan-Long ChuangHepatobiliary Division, Department of Internal Medicine, and Hepatitis Center, Kaohsiung Medical University Hospital, School of Medicine, College of Medicine, Kaohsiung Medical University, No. 100, Tzyou 1st Road, Kaohsiung, 807, Taiwan.
Lewis RobertsDivision of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA.
Dae Won JunDivision of Gastroenterology and Hepatology, Department of Internal Medicine, Hanyang University Seoul Hospital, Seoul, Korea.
Hidenori ToyodaDepartment of Gastroenterology, Ogaki Municipal Hospital, Ogaki, Japan.
Satoshi YasudaDepartment of Gastroenterology, Ogaki Municipal Hospital, Ogaki, Japan.
Mindie H Nguyen *Division of Gastroenterology and Hepatology, Stanford University, Palo Alto, CA, USA. mindiehn@stanford.edu.
Ming-Lung Yu *Hepatobiliary Division, Department of Internal Medicine, and Hepatitis Center, Kaohsiung Medical University Hospital, School of Medicine, College of Medicine, Kaohsiung Medical University, No. 100, Tzyou 1st Road, Kaohsiung, 807, Taiwan. fish6069@gmail.com.ORCID http://orcid.org/0000-0001-8145-1900
Kaohsiung Medical University · TWE-Da Hospital · TWI-Shou University · TWOgaki Municipal Hospital · JPChina Medical University · TWHanyang University Seoul Hospital · KRMayo Clinic in Arizona · USStanford Medicine · US

Funding

E-Da Hospital EDAHP109044E-Da Hospital EDAHP109045E-Da Hospital EDAHP109053E-Da Hospital EDPJ105056E-Da Hospital EDPJ106094E-Da Hospital EDPJ107076E-Da Hospital EDPJ1080696E-Da Hospital-National Taiwan University Hospital Joint Research Program 108-EDN11E-Da Hospital-National Taiwan University Hospital Joint Research Program 109-EDN03Kaohsiung Medical University Grant Center of Cancer Research KMU-TCA04-3Kaohsiung Medical University Grant KMU-DK109002Kaohsiung Medical University Grant Research Center Grant, Cohort Research Center KMU-TC108B07Ministry of Science and Technology, Taiwan 105-2314-B-650-004-MY3Ministry of Science and Technology, Taiwan 108-2314-B-214-006-MY2
6 · The paper itself

Abstract

backgroundPatients with Barcelona Clinic Liver Cancer Stage C (BCLC-C) hepatocellular carcinoma (HCC) can be markedly heterogeneous with varying prognosis. This study aims to establish a new subclassification system for BCLC-C HCC to better predict overall survival (OS) and to tailor therapy.

methodsWe retrospectively studied 1856 BCLC-C HCC patients between 2006 and 2017 from E-Da Hospital, Taiwan (n = 622, training cohort), Kaohsiung Medical University Hospital, Taiwan (n = 774, Taiwan validation cohort), and Stanford University Medical Center and Mayo Clinic (United States), Hanyang University Hospital (South Korea), and Ogaki Municipal Hospital (Japan) to make up the international validation cohort (n = 460).

resultsIn the training cohort, significant factors associated with OS were largest tumor size ≥ 10 cm, extrahepatic spread, macrovascular invasion, and Child-Pugh class, which provided the basis, together with aged ≥ 75 years, for the substaging, through C0 to C4, of BCLC-C HCC patients. The median OS for substages C0, C1, C2, C3, and C4 were 43.8 months (95% confidence interval [CI] 32.2-53.7), 20.6 months (CI 14.1-25.9), 11.5 months (CI 8.02-14.1), 5.7 months (CI 4.02-5.98), and 3.2 months (CI 2.41-3.59), respectively, (p < 0.05). OS remained distinct among the proposed substages in the Taiwan validation cohort as well as the international validation cohort. The distinction between the substages persisted in subgroup analysis by substage combined with treatment modality. In substage C0-C3, patients receiving HCC curative therapy had a significantly better median OS than those receiving sorafenib or palliative therapy.

conclusionOur new substaging system provides more precise prognosis to better tailor therapy for BCLC-C HCC patients.

Indexed as

Carcinoma, HepatocellularLiver NeoplasmsAgedHumansNeoplasm StagingPrognosisRetrospective StudiesSorafenibSorafenibAdvanced stageHepatocellular carcinomaImmunotherapyOverall survivalPredictive factorsPrognosisSubstageSurgical resectionTarget therapyTreatment

Identifiers

PMID34008091
OpenAlexW3161932481

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.