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Prognostic accuracy of staging systems in patients with primary liver cancer treated with transarterial chemoembolization
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摘要: 目的探索肝癌肝动脉化疗栓塞术（TACE）术后患者预后评价的有效分期。方法回顾性分析2006年9月至2009年5月间行TACE治疗的原发性肝癌患者的临床随访资料,比较CTP分级、MELD评分、Okuda分期、BCLC分级、CS分期和Tokyo评分对TACE治疗后生存情况的预测能力的差异。结果 Kaplan-Meier生存曲线及log-rank检验结果显示,Okuda分期各期别间差异均有统计学意义（ⅠvsⅡP=0.013,ⅡvsⅢP<0.001）;BCLC分级B级与C级间差异有统计学意义（P=0.008）;CS分期Ⅱ期同Ⅲ期之间差异具有统计学意义（P=0.001）。Cox多因素回归分析得到Okuda分期（P=0.039）、BCLC分级（P=0.022）有统计学意义。BCLC分级同时具有最小的-2Ln（L）、AIC、SBC值,分别为205.419、209.419、212.586。结论 BCLC分级对TACE治疗后的生存情况具有较好的预测作用,可能有助于选择适宜行TACE治疗的患者。Abstract: Objective To compare the performance of 6 available prognostic staging systems in predicting the survival of patients with primary liver cancer treated with TACE.Methods The clinical data of patients who had been diagnosed as liver cancer in our department from September 2006 to May 2009 were retrospectively analyzed to compare the CTP classification, the MELD scoring, the BCLC classification system, the CS staging system and the Tokyo scoring.Results The survival curves and log-rank test shows statistical significance in all stages of the Okuda staging system (Ⅰvs Ⅱ P=0.013, Ⅱvs Ⅲ P<0.001) , between stage B and C of the BCLC classification system (P=0.008) and between stage II and III of the CS staging system (P=0.001) .By the multiple factor regression method, the Okuda staging system (P=0.039) and the BCLC classification (P=0.022) also show a stronger significance on the prognosis.And the BCLC classification system is superior to the other staging systems with the minimum value of-2Ln (L) (205.419) , AIC (209.419) , SBC (212.586) .Conclusion The BCLC classification system provides the best prognostic stratification for a cohort of the patients with liver cancer treated with transarterial chemoembolization.
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Key words:
- liver neoplasms /
- hepatic artery /
- chemoembolization
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