TY - JOUR
T1 - Overview of prognostic systems for hepatocellular carcinoma and ITA.LI.CA external validation of MESH and CNLC classifications
AU - Associazione Italiana per lo Studio del Fegato (AISF) HCC Special Interest Group
AU - Italian Liver Cancer (ITA.LI.CA) Study Group
AU - Vitale, Alessandro
AU - Farinati, Fabio
AU - Finotti, Michele
AU - Di Renzo, Chiara
AU - Brancaccio, Giuseppina
AU - Piscaglia, Fabio
AU - Cabibbo, Giuseppe
AU - Caturelli, Eugenio
AU - Missale, Gabriele
AU - Marra, Fabio
AU - Giannini, Edoardo G.
AU - Trevisani, Franco
AU - Bhoori, S.
AU - Casadei Gardini, A.
AU - Conti, F.
AU - Cozzolongo, R.
AU - Di Costanzo, G. G.
AU - Foschi, F. G.
AU - Fucilli, F.
AU - Galati, G.
AU - Gasbarrini, A.
AU - Giuliante, F.
AU - Grieco, A.
AU - Gruttadauria, S.
AU - Guarino, M.
AU - Iavarone, M.
AU - Marasco, G.
AU - Miele, L.
AU - Pagano, D.
AU - Persico, M.
AU - Pompili, M.
AU - Rapaccini, G. L.
AU - Rendina, M.
AU - Renzulli, M.
AU - Romano, F.
AU - Rossi, M.
AU - Russo, F. P.
AU - Sangiovanni, A.
AU - Sessa, A.
AU - Sposito, C.
AU - Viganò, L.
AU - Viganò, M.
AU - Villa, E.
AU - Azzaroli, F.
AU - Gasbarrini, A.
AU - Foschi, F. G.
AU - Guarino, M.
AU - Mega, A.
AU - Rapaccini, G. L.
AU - Zoli, M.
N1 - Publisher Copyright:
© 2021 by the authors. Licensee MDPI, Basel, Switzerland.
PY - 2021/4/1
Y1 - 2021/4/1
N2 - Prognostic assessment in patients with HCC remains an extremely difficult clinical task due to the complexity of this cancer where tumour characteristics interact with degree of liver dysfunction, patient general health status, and a large span of available treatment options. Several prognostic systems have been proposed in the last three decades, both from the Asian and European/North American countries. Prognostic scores, such as the CLIP score and the recent MESH score, have been generated on a solid statistical basis from real life population data, while staging systems, such as the BCLC scheme and the recent CNLC classification, have been created by experts according to recent HCC prognostic evidences from the literature. A third category includes combined prognostic systems that can be used both as prognostic scores and staging systems. A recent example is the ITA.LI.CA prognostic system including either a prognostic score and a simplified staging system. This review focuses first on an overview of the main prognostic systems for HCC classified according to the above three categories, and, second, on a comprehensive description of the methodology required for a correct comparison between different systems in terms of prognostic performance. In this second section the main studies in the literature comparing different prognostic systems are described in detail. Lastly, a formal comparison between the last prognostic systems proposed for each of the above three categories is performed using a large Italian database including 6882 HCC patients in order to concretely apply the comparison rules previously described.
AB - Prognostic assessment in patients with HCC remains an extremely difficult clinical task due to the complexity of this cancer where tumour characteristics interact with degree of liver dysfunction, patient general health status, and a large span of available treatment options. Several prognostic systems have been proposed in the last three decades, both from the Asian and European/North American countries. Prognostic scores, such as the CLIP score and the recent MESH score, have been generated on a solid statistical basis from real life population data, while staging systems, such as the BCLC scheme and the recent CNLC classification, have been created by experts according to recent HCC prognostic evidences from the literature. A third category includes combined prognostic systems that can be used both as prognostic scores and staging systems. A recent example is the ITA.LI.CA prognostic system including either a prognostic score and a simplified staging system. This review focuses first on an overview of the main prognostic systems for HCC classified according to the above three categories, and, second, on a comprehensive description of the methodology required for a correct comparison between different systems in terms of prognostic performance. In this second section the main studies in the literature comparing different prognostic systems are described in detail. Lastly, a formal comparison between the last prognostic systems proposed for each of the above three categories is performed using a large Italian database including 6882 HCC patients in order to concretely apply the comparison rules previously described.
KW - Discrimination ability
KW - Hepatocellular carcinoma
KW - Homogeneity
KW - Mono-tonicity of gradients
KW - Prognostic performance
KW - Prognostic system
UR - http://www.scopus.com/inward/record.url?scp=85103480336&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85103480336&partnerID=8YFLogxK
U2 - 10.3390/cancers13071673
DO - 10.3390/cancers13071673
M3 - Review article
AN - SCOPUS:85103480336
VL - 13
SP - 1673
JO - Cancers
JF - Cancers
SN - 2072-6694
IS - 7
ER -