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Prognostic Performance of the China Liver Cancer Staging System in Hepatocellular Carcinoma Following Transarterial Chemoembolization.
Journal of Clinical and Translational Hepatology ( IF 3.6 ) Pub Date : 2023-07-07 , DOI: 10.14218/jcth.2023.00099 Bin-Yan Zhong 1 , Jian-Qiang Jiang 2 , Jun-Hui Sun 3 , Jin-Tao Huang 1 , Wei-Dong Wang 4 , Qi Wang 5 , Wen-Bin Ding 6 , Xiao-Li Zhu 1 , Cai-Fang Ni 1
Journal of Clinical and Translational Hepatology ( IF 3.6 ) Pub Date : 2023-07-07 , DOI: 10.14218/jcth.2023.00099 Bin-Yan Zhong 1 , Jian-Qiang Jiang 2 , Jun-Hui Sun 3 , Jin-Tao Huang 1 , Wei-Dong Wang 4 , Qi Wang 5 , Wen-Bin Ding 6 , Xiao-Li Zhu 1 , Cai-Fang Ni 1
Affiliation
Background and Aims
To validate prognostic performance of the China liver cancer (CNLC) staging system as well as to compare these parameters with those of the Barcelona Clinic Liver Cancer (BCLC) staging system for Chinese hepatocellular carcinoma (HCC) treated with transarterial chemoembolization (TACE).
Methods
This multicenter retrospective study included 1,124 patients with HCC between January 2012 and December 2020 from six Chinese hospitals. Based on overall survival (OS), the prognostic performance outcomes for the CNLC and BCLC staging systems were compared by model discrimination [C statistic and Akaike information criterion (AIC)], monotonicity of the gradient (linear trend chi-square test), homogeneity (likelihood ratio chi-square test), and calibration (calibration plots). A prospective cohort of 44 patients receiving TACE-based therapy included between January 2021 and December 2022 was used to prospectively validate the outcomes.
Results
Median OS was 19.1 (18.2-20.0) months, with significant differences in OS between stages defined by the CNLC and BCLC observed (p<0.001). The CNLC performed better than the BCLC regarding model discrimination (C-index: 0.661 vs. 0.644; AIC: 10,583.28 vs. 10,583.72), model monotonicity of the gradient (linear trend chi-square test: 66.107 vs. 57.418; p<0.001), model homogeneity (159.2 vs. 158.7; p<0.001). Both staging systems had good model calibration. Similar results were observed in the prospective cohort.
Conclusions
Combining model discrimination, gradient monotonicity, homogeneity, and calibration, the CNLC performed better than the BCLC for Chinese HCC patients receiving TACE.
更新日期：2023-07-07
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