Validation of three staging systems for hepatocellular carcinoma (JIS score, biomarker-combined JIS score and BCLC system) in 4,649 cases from a Japanese nationwide survey

Satoshi Kitai, Masatoshi Kudo, Namiki Izumi, Shuichi Kaneko, Yonson Ku, Norihiro Kokudo, Michiie Sakamoto, Tadatoshi Takayama, Osamu Nakashima, Masumi Kadoya, Yutaka Matsuyama, Takashi Matsunaga

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Objective: Clinical staging is very important for optimal therapeutic strategy and prognostic prediction in patients with hepatocellular carcinoma (HCC). The Barcelona Clinic Liver Cancer (BCLC) staging system is the most widely used and best-validated method for HCC. Similarly, the conventional Japan Integrated Staging (c-JIS) score and the biomarker-combined JIS (bm-JIS) score have also been reported to effectively stratify HCC patients. The aim of this study was to evaluate the performance of these three staging systems for prognostic prediction.

Methods: A total of 4,649 HCC patients were included in this study. A multivariate analysis identified the independent risk factors associated with overall survival. The stratification ability and the suitability as a prognostic model of the three staging systems were compared.

Results: Multivariate analysis revealed that male sex, higher Child-Pugh score, tumor size >2.0 cm, multiple tumors, vascular invasion, higher alpha-fetoprotein (AFP) level, higher des-gamma-carboxyprothrombin level, higher Lens culinaris agglutinin-reactive AFP level, and a performance status of 3-4 were independent risk factors in HCC. The independent homogenizing ability and stratification value of the bm-JIS score were higher than those of the c-JIS score and the BCLC system (χ2 = 972.7581, 758.1041 and 679.6832, respectively). Moreover, the bm-JIS score had the lowest Akaike Information Criteria value, followed by the c-JIS score and the BCLC system (9,844.278, 10,054.93 and 10,131.35, respectively).

Conclusions: Our results suggest that the bm-JIS score offers good stratification ability and is a better prognostic predictor than the c-JIS score and the BCLC system.

Original languageEnglish
Pages (from-to)717-724
Number of pages8
JournalDigestive Diseases
Volume32
Issue number6
DOIs
Publication statusPublished - 2014 Nov 19

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Liver Neoplasms
Hepatocellular Carcinoma
Biomarkers
Japan
alpha-Fetoproteins
Multivariate Analysis
Neoplasm Staging
Blood Vessels
Neoplasms
Surveys and Questionnaires
Survival
Therapeutics

ASJC Scopus subject areas

  • Gastroenterology

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Validation of three staging systems for hepatocellular carcinoma (JIS score, biomarker-combined JIS score and BCLC system) in 4,649 cases from a Japanese nationwide survey. / Kitai, Satoshi; Kudo, Masatoshi; Izumi, Namiki; Kaneko, Shuichi; Ku, Yonson; Kokudo, Norihiro; Sakamoto, Michiie; Takayama, Tadatoshi; Nakashima, Osamu; Kadoya, Masumi; Matsuyama, Yutaka; Matsunaga, Takashi.

In: Digestive Diseases, Vol. 32, No. 6, 19.11.2014, p. 717-724.

Research output: Contribution to journalArticle

Kitai, S, Kudo, M, Izumi, N, Kaneko, S, Ku, Y, Kokudo, N, Sakamoto, M, Takayama, T, Nakashima, O, Kadoya, M, Matsuyama, Y & Matsunaga, T 2014, 'Validation of three staging systems for hepatocellular carcinoma (JIS score, biomarker-combined JIS score and BCLC system) in 4,649 cases from a Japanese nationwide survey', Digestive Diseases, vol. 32, no. 6, pp. 717-724. https://doi.org/10.1159/000368008
Kitai, Satoshi ; Kudo, Masatoshi ; Izumi, Namiki ; Kaneko, Shuichi ; Ku, Yonson ; Kokudo, Norihiro ; Sakamoto, Michiie ; Takayama, Tadatoshi ; Nakashima, Osamu ; Kadoya, Masumi ; Matsuyama, Yutaka ; Matsunaga, Takashi. / Validation of three staging systems for hepatocellular carcinoma (JIS score, biomarker-combined JIS score and BCLC system) in 4,649 cases from a Japanese nationwide survey. In: Digestive Diseases. 2014 ; Vol. 32, No. 6. pp. 717-724.
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abstract = "Objective: Clinical staging is very important for optimal therapeutic strategy and prognostic prediction in patients with hepatocellular carcinoma (HCC). The Barcelona Clinic Liver Cancer (BCLC) staging system is the most widely used and best-validated method for HCC. Similarly, the conventional Japan Integrated Staging (c-JIS) score and the biomarker-combined JIS (bm-JIS) score have also been reported to effectively stratify HCC patients. The aim of this study was to evaluate the performance of these three staging systems for prognostic prediction.Methods: A total of 4,649 HCC patients were included in this study. A multivariate analysis identified the independent risk factors associated with overall survival. The stratification ability and the suitability as a prognostic model of the three staging systems were compared.Results: Multivariate analysis revealed that male sex, higher Child-Pugh score, tumor size >2.0 cm, multiple tumors, vascular invasion, higher alpha-fetoprotein (AFP) level, higher des-gamma-carboxyprothrombin level, higher Lens culinaris agglutinin-reactive AFP level, and a performance status of 3-4 were independent risk factors in HCC. The independent homogenizing ability and stratification value of the bm-JIS score were higher than those of the c-JIS score and the BCLC system (χ2 = 972.7581, 758.1041 and 679.6832, respectively). Moreover, the bm-JIS score had the lowest Akaike Information Criteria value, followed by the c-JIS score and the BCLC system (9,844.278, 10,054.93 and 10,131.35, respectively).Conclusions: Our results suggest that the bm-JIS score offers good stratification ability and is a better prognostic predictor than the c-JIS score and the BCLC system.",
author = "Satoshi Kitai and Masatoshi Kudo and Namiki Izumi and Shuichi Kaneko and Yonson Ku and Norihiro Kokudo and Michiie Sakamoto and Tadatoshi Takayama and Osamu Nakashima and Masumi Kadoya and Yutaka Matsuyama and Takashi Matsunaga",
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T1 - Validation of three staging systems for hepatocellular carcinoma (JIS score, biomarker-combined JIS score and BCLC system) in 4,649 cases from a Japanese nationwide survey

AU - Kitai, Satoshi

AU - Kudo, Masatoshi

AU - Izumi, Namiki

AU - Kaneko, Shuichi

AU - Ku, Yonson

AU - Kokudo, Norihiro

AU - Sakamoto, Michiie

AU - Takayama, Tadatoshi

AU - Nakashima, Osamu

AU - Kadoya, Masumi

AU - Matsuyama, Yutaka

AU - Matsunaga, Takashi

PY - 2014/11/19

Y1 - 2014/11/19

N2 - Objective: Clinical staging is very important for optimal therapeutic strategy and prognostic prediction in patients with hepatocellular carcinoma (HCC). The Barcelona Clinic Liver Cancer (BCLC) staging system is the most widely used and best-validated method for HCC. Similarly, the conventional Japan Integrated Staging (c-JIS) score and the biomarker-combined JIS (bm-JIS) score have also been reported to effectively stratify HCC patients. The aim of this study was to evaluate the performance of these three staging systems for prognostic prediction.Methods: A total of 4,649 HCC patients were included in this study. A multivariate analysis identified the independent risk factors associated with overall survival. The stratification ability and the suitability as a prognostic model of the three staging systems were compared.Results: Multivariate analysis revealed that male sex, higher Child-Pugh score, tumor size >2.0 cm, multiple tumors, vascular invasion, higher alpha-fetoprotein (AFP) level, higher des-gamma-carboxyprothrombin level, higher Lens culinaris agglutinin-reactive AFP level, and a performance status of 3-4 were independent risk factors in HCC. The independent homogenizing ability and stratification value of the bm-JIS score were higher than those of the c-JIS score and the BCLC system (χ2 = 972.7581, 758.1041 and 679.6832, respectively). Moreover, the bm-JIS score had the lowest Akaike Information Criteria value, followed by the c-JIS score and the BCLC system (9,844.278, 10,054.93 and 10,131.35, respectively).Conclusions: Our results suggest that the bm-JIS score offers good stratification ability and is a better prognostic predictor than the c-JIS score and the BCLC system.

AB - Objective: Clinical staging is very important for optimal therapeutic strategy and prognostic prediction in patients with hepatocellular carcinoma (HCC). The Barcelona Clinic Liver Cancer (BCLC) staging system is the most widely used and best-validated method for HCC. Similarly, the conventional Japan Integrated Staging (c-JIS) score and the biomarker-combined JIS (bm-JIS) score have also been reported to effectively stratify HCC patients. The aim of this study was to evaluate the performance of these three staging systems for prognostic prediction.Methods: A total of 4,649 HCC patients were included in this study. A multivariate analysis identified the independent risk factors associated with overall survival. The stratification ability and the suitability as a prognostic model of the three staging systems were compared.Results: Multivariate analysis revealed that male sex, higher Child-Pugh score, tumor size >2.0 cm, multiple tumors, vascular invasion, higher alpha-fetoprotein (AFP) level, higher des-gamma-carboxyprothrombin level, higher Lens culinaris agglutinin-reactive AFP level, and a performance status of 3-4 were independent risk factors in HCC. The independent homogenizing ability and stratification value of the bm-JIS score were higher than those of the c-JIS score and the BCLC system (χ2 = 972.7581, 758.1041 and 679.6832, respectively). Moreover, the bm-JIS score had the lowest Akaike Information Criteria value, followed by the c-JIS score and the BCLC system (9,844.278, 10,054.93 and 10,131.35, respectively).Conclusions: Our results suggest that the bm-JIS score offers good stratification ability and is a better prognostic predictor than the c-JIS score and the BCLC system.

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