Aims: To compare the prognostic efficacy of the 5th and 6th edition of the TNM staging system for HCC. Methods: We retrospectively applied the old and the new systems to 393 resected patients, comparing the efficacy of both in prognostic evaluation. Results: The 1-, 3- and 5-year overall survival rates were 89.7, 71.1 and 56.3%, respectively. The 1-, 3- and 5-year disease-free survival rates were 79.4, 54.6 and 39.4%, respectively. Among the factors evaluated, Child's grade B and C (p=0.001) and presence of multiple nodules (p=0.01) were found to be related either to a worse long-term survival or to a worse disease-free survival. Stratifying patient survivals according to the old TNM system, we found significant differences only between stages II and IIIA (p=0.001); otherwise stages I and II (p=0.9) as well as stages IIIA and IVA (p=0.9) showed similar survival rates. Analysing the new TNM system, we found a more homogeneous staging stratification, with significant differences both between stage I and II (p=0.02) and between stage II and IIIA (p=0.05). Conclusions: In the present multicentric study, long term overall and disease-free survival after liver resection for HCC was strongly affected by the number of tumours and the underlying liver disease. Our results suggest that the new classification appears to achieve an accurate stratification of patients, simpler than the previous edition, as well as a more reliable comparative analysis of outcome after hepatic resection for HCC. © 2005 Elsevier Ltd. All rights reserved.

Comparison between the fifth and sixth editions of the AJCC/UICC TNM staging systems for hepatocellular carcinoma: multicentric study on 393 cirrhotic resected patients / VAROTTI, GIOVANNI; Ramacciato G; ERCOLANI, GIORGIO; GRAZI, GIAN LUCA; VETRONE, GAETANO; CESCON, MATTEO; DEL GAUDIO, MASSIMO; RAVAIOLI, MATTEO; Ziparo V; Lauro A; PINNA, ANTONIO DANIELE. - In: EUROPEAN JOURNAL OF SURGICAL ONCOLOGY. - ISSN 0748-7983. - STAMPA. - 31:(2005), pp. 760-767. [10.1016/j.ejso.2005.04.008]

Comparison between the fifth and sixth editions of the AJCC/UICC TNM staging systems for hepatocellular carcinoma: multicentric study on 393 cirrhotic resected patients

GRAZI, GIAN LUCA;
2005

Abstract

Aims: To compare the prognostic efficacy of the 5th and 6th edition of the TNM staging system for HCC. Methods: We retrospectively applied the old and the new systems to 393 resected patients, comparing the efficacy of both in prognostic evaluation. Results: The 1-, 3- and 5-year overall survival rates were 89.7, 71.1 and 56.3%, respectively. The 1-, 3- and 5-year disease-free survival rates were 79.4, 54.6 and 39.4%, respectively. Among the factors evaluated, Child's grade B and C (p=0.001) and presence of multiple nodules (p=0.01) were found to be related either to a worse long-term survival or to a worse disease-free survival. Stratifying patient survivals according to the old TNM system, we found significant differences only between stages II and IIIA (p=0.001); otherwise stages I and II (p=0.9) as well as stages IIIA and IVA (p=0.9) showed similar survival rates. Analysing the new TNM system, we found a more homogeneous staging stratification, with significant differences both between stage I and II (p=0.02) and between stage II and IIIA (p=0.05). Conclusions: In the present multicentric study, long term overall and disease-free survival after liver resection for HCC was strongly affected by the number of tumours and the underlying liver disease. Our results suggest that the new classification appears to achieve an accurate stratification of patients, simpler than the previous edition, as well as a more reliable comparative analysis of outcome after hepatic resection for HCC. © 2005 Elsevier Ltd. All rights reserved.
2005
31
760
767
VAROTTI, GIOVANNI; Ramacciato G; ERCOLANI, GIORGIO; GRAZI, GIAN LUCA; VETRONE, GAETANO; CESCON, MATTEO; DEL GAUDIO, MASSIMO; RAVAIOLI, MATTEO; Ziparo V; Lauro A; PINNA, ANTONIO DANIELE
File in questo prodotto:
File Dimensione Formato  
2005 (Eur J Surg Oncol) Varotti - Comparison between the fifth.pdf

Accesso chiuso

Dimensione 133.82 kB
Formato Adobe PDF
133.82 kB Adobe PDF   Visualizza/Apri   Richiedi una copia

I documenti in FLORE sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificatore per citare o creare un link a questa risorsa: https://hdl.handle.net/2158/1301374
Citazioni
  • ???jsp.display-item.citation.pmc??? ND
  • Scopus 61
  • ???jsp.display-item.citation.isi??? 51
social impact