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Usefulness of staging systems and prognostic scores for hepatocellular carcinoma treatments

World Journal of Hepatology 2016年第17期8卷 703-715页

作者： Xavier Adhoute Guillaume Penaranda Jean Luc Raoul Patrice Le Treut emilie bollon Jean Hardwigsen Paul Castellani Hervé Perrier Marc Bourlière Department of Hepato-Gastroenterology Hopital Saint-Joseph Alpha Bio Laboratory Department of Hepato-Gastroenterology and Digestive Oncology Institut Paoli-Calmette Department of Hepatobiliary Surgery Centre Hospitalo-Universitaire Timone

Therapeutic management of hepatocellular carcinoma(HCC) is quite complex owing to the underlying cirrhosis and portal vein hypertension. Different scores or classification systems based on liver function and tumoral stages have been published in the recent years. If none of them is currently "universally" recognized, the Barcelona Clinic Liver Cancer(BCLC) staging system has become the reference classification system in Western countries. Based on a robust treatment algorithm associated with stage stratification, it relies on a high level of evidence. However, BCLC stage B and C HCC include a broad spectrum of tumors but are only matched with a single therapeutic option. Some experts have thus suggested to extend the indications for surgery or for transarterial chemoembolization. In clinical practice, many patients are already treated beyond the scope of recommendations. Additional alternative prognostic scores that could be applied to any therapeutic modality have been recently proposed. They could represent complementary tools to the BCLC staging system and improve the stratification of HCC patients enrolled in clinical trials, as illustrated by the NIACE score. Prospective studies are needed to compare these scores and refine their role in the decision making process.

关键词： Scoring system Hepatocellular carcinoma Barcelona Clinic Liver Cancer staging system NIACE Transarterial chemoembolization

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