Natural Historory of Hepatocellular Carcinoma and a Staging System according to Prognostic Index

Hyun, Jin Hai; Lee, Sang Woo; Song, Chi Wook; Ryu, Ho Sang; Kim, Chang Duck; Chun, Hoon Jae; Jeen, Yoon Tae; Um, Soon Ho; Lee, Jae Won; Park, Mi Ra; Kim, Yoon Hwan; Seo, Sung Ok; Jang, Byeong Ik

Abstract

BACKGROUND/AIMS: Well designed staging system of hepatocellular carcinoma(HCC) is needed for comparative therapeutic studies regarding HCC to be of value. The aim of study is to reevaluate prognostic factors affecting natural history of HCC and to devise a staging system according to prognostic index estimated mathematical.
METHODS
One hundred eighty patients with HCC were analyzed retrospectively. All patients received only conservative treatments. Univariate and multivariate analysis were performed using clinical, biochemical and imaging data obtained at diagnosis.
RESULTS
The overall acturial survival rate at 1, 3, 6, 12, 24 months were 74%, 33%, 11%, 7%, 5%, respectively. For significant prognostic variables in the univariate analysis, multivariate survival analysis disclosed that tumor size(p=0.0039), ascites(p<0.0190), total serum bilirubin(p=0.001) were independent prognostic factors. Considering the contribution of each of these factors to prediction of survial, a pronostic index(PI) was defined as a following regression equation. PI=EXP(tumor size X0,1904+ascitesX0.4114+Bilirubin X0.0504). Accorcling to Pl, a new staging system was devised Following division of patients into three groups with significantly different survival rates(p<0.01).
CONCLUSIONS
The new staging system for HCC according to PI would be useful for the staratification of HCC patients in the comparative evaluation of various therapeutic modalities.