International validation of the Chinese University Prognostic Index for staging of hepatocellular carcinoma:a joint United Kingdom and Hong Kong study |
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| Authors: | Stephen LChan Philip JJohnson Frankie Mo Sarah Berhane Mabel Teng Anthony WH Chan Ming CPoon Paul BS Lai Simon Yu Anthony TC Chan Winnie Yeo |
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| Affiliation: | Stephen LChan(State Key Laboratory in 0ncology in South China, Sir YK Pao Center for Cancer, Department of Clinical 0ncology, Hong Kong Cancer Institute and Prince of Wales Hospital)；Philip JJohnson(School of Cancer Sciences, University of Birmingham, Birmingham B15 2TT, United Kingdom)；Frankie Mo(State Key Laboratory in 0ncology in South China, Sir YK Pao Center for Cancer, Department of Clinical 0ncology, Hong Kong Cancer Institute and Prince of Wales Hospital)；Sarah Berhane(School of Cancer Sciences, University of Birmingham, Birmingham B15 2TT, United Kingdom)；Mabel Teng(School of Cancer Sciences, University of Birmingham, Birmingham B15 2TT, United Kingdom)；Anthony WH Chan(Department of Anatomical, Celular and Pathology, The Chinese University of Hong Kong, Shatin, Hong Kong, China)；Ming CPoon(State Key Laboratory in 0ncology in South China, Sir YK Pao Center for Cancer, Department of Clinical 0ncology, Hong Kong Cancer Institute and Prince of Wales Hospital)；Paul BS Lai(Department of Surgery, The Chinese University of Hong Kong, Shatin, Hong Kong, China)；Simon Yu(Department of Radiology and 0rgan Imaging, The Chinese University of Hong Kong, Shatin, Hong Kong, China)；Anthony TC Chan(State Key Laboratory in 0ncology in South China, Sir YK Pao Center for Cancer, Department of Clinical 0ncology, Hong Kong Cancer Institute and Prince of Wales Hospital)；Winnie Yeo(State Key Laboratory in 0ncology in South China, Sir YK Pao Center for Cancer, Department of Clinical 0ncology, Hong Kong Cancer Institute and Prince of Wales Hospital)； |
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| Abstract: | The outcome of hepatocellular carcinoma (HCC) patients significantly differs between western and eastern population centers. Our group previously developed and validated the Chinese University Prognostic Index (CUPI) for the prognostication of HCC among the Asian HCC patient population. In the current study, we aimed to validate the CUPI using an international cohort of patients with HCC and to compare the CUPI to two widely used staging systems, the Barcelona Clinic Liver Cancer (BCLC) classification and the Cancer of the Liver Italian Program (CLIP). To accomplish this goal, two cohorts of patients were enrolled in the United Kingdom (UK;n = 567; 2006-2011) and Hong Kong (HK;n = 517; 2007-2012). The baseline clinical data were recorded. The performances of the CUPI, BCLC, and CLIP were compared in terms of a concordance index (C-index) and were evaluated in subgroups of patients according to treatment intent. The results revealed that the median folow-up durations of the UK and HK cohorts were 27.9 and 29.8 months, respectively. The median overal survival of the UK and HK cohorts were 22.9 and 8.6 months, respectively. The CUPI stratified the patients in both cohorts into three risk subgroups corresponding to distinct outcomes. The median overal survival of the CUPI low-, intermediate-, and high-risk subgroups were 3.15, 1.24, and 0.29 years, respectively, in the UK cohort and were 2.07, 0.32, and 0.10 years, respectively, in the HK cohort. For the patients who underwent curative treatment, the prognostic performance did not differ between the three staging systems, and all were suboptimal. For those who underwent paliative treatment, the CUPI displayed the highest C-index, indicating that this staging system was the most informative for both cohorts. In conclusion, the CUPI is applicable to both western and eastern HCC patient populations. The performances of the three staging systems differed according to treatment intent, and the CUPI was demonstrated to be optimal for those undergoing paliative treatment. A more precise staging system for early-stage disease patients is required. |
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| Keywords: | Liver neoplasms staging international cooperation therapeutics |
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