ArticleWorld journal of hepatology2025
Comparative prognostic performance of staging systems for hepatocellular carcinoma: Evidence from a Vietnamese cohort study.
Article in World journal of hepatology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundHepatocellular carcinoma (HCC), the sixth most common cancer and fourth-leading cause of cancer-related mortality globally, imposes a significant burden in Vietnam due to endemic hepatitis B virus (HBV) and hepatitis C virus (HCV) infections. Accurate prognostication is crucial for optimizing treatment and outcomes. Numerous staging systems exist, including the Barcelona Clinic Liver Cancer (BCLC), Hong Kong Liver Cancer (HKLC), cancer of the liver Italian Program (CLIP), Italian Liver Cancer (ITA.LI.CA), Japan Integrated Staging (JIS), Tokyo Score, and model to estimate survival in ambulatory HCC patients (MESIAH). However, their comparative performance in Vietnamese patients remains underexplored.
aimTo compare the prognostic accuracy of seven HCC staging systems in predicting survival and identify the optimal model.
methodsThis retrospective cohort study included 987 patients with HCC diagnosed at Nhan dan Gia Dinh Hospital, Vietnam, from January 2016 to December 2023. Patients were staged using BCLC, HKLC, CLIP, ITA.LI.CA, JIS, Tokyo score, and MESIAH. Overall survival was analyzed using Kaplan-Meier methods, and prognostic performance was evaluated
resultsThe HKLC and BCLC systems demonstrated the highest discriminatory ability, with area under the ROC curves of 0.834 and 0.830, respectively, at 12 months and 0.859 for both systems at 36 months. CLIP and ITA.LI.CA exhibited superior calibration, particularly at 36 months. The JIS system consistently showed the poorest discriminatory performance. Subgroup analyses revealed that HKLC maintained strong performance across different viral etiologies (HBV, HCV, non-B-non-C) and treatment modalities (transarterial chemoembolization, surgery, ablation).
conclusionThe HKLC and BCLC systems showed superior prognostic performance for Vietnamese patients with HCC, supporting HKLC adoption in clinical practice.
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