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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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Chinese Journal of Cancer 2014年第10期33卷 481-491页

作者： Stephen L.Chan Philip J.Johnson Frankie Mo sarah berhane Mabel Teng Anthony W.H.Chan Ming C.Poon Paul B.S.Lai Simon Yu Anthony T.C.Chan Winnie Yeo State Key Laboratory in Oncology in South China Sir YK Pao Center for CancerDepartment of Clinical OncologyHong Kong Cancer Institute and Prince of Wales HospitalThe Chinese University of Hong Kong School of Cancer Sciences University of Birmingham the Department of Molecular and Clinical Cancer Medicine Institute of Translational MedicineUniversity of Liverpool Department of Anatomical Cellular and PathologyThe Chinese University of Hong Kong Department of Surgery The Chinese University of Hong Kong Department of Radiology and Organ Imaging The Chinese University of Hong Kong

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 follow-up durations of the UK and HK cohorts were 27.9 and 29.8 months, respectively. The median overall 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 overall 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 palliative 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 opti

关键词：香港英国预后肝癌验证国际大学中国

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