Comparative prognostic performance of staging systems for hepatocellular carcinoma: Evidence from a Vietnamese cohort study
Year: 2025
Type: article
Study design: Observational Study
Abstract: BACKGROUND: Hepatocellular 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. AIM: To compare the prognostic accuracy of seven HCC staging systems in predicting survival and identify the optimal model. METHODS: the area under the receiver operating characteristic (ROC) curve, Harrell's concordance index, and calibration plots. RESULTS: The 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). CONCLUSION: The HKLC and BCLC systems showed superior prognostic performance for Vietnamese patients with HCC, supporting HKLC adoption in clinical practice.
Source: World Journal of Hepatology
Authors: Tuong-Anh Mai-Phan, Trong-Kha Nguyen, Tri-Nhan Pham, Minh-Quang Tran, Kim-Long Le
Language: English
Subfield: Hepatology
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W4410735064