Advances in post-operative prognostic models for hepatocellular carcinoma

J Zhejiang Univ Sci B. 2023 Mar 15;24(3):191-206. doi: 10.1631/jzus.B2200067.
[Article in English, Chinese]

Abstract

Hepatocellular carcinoma (HCC) is one of the most common malignancies and a leading cause of cancer-related death worldwide. Surgery remains the primary and most successful therapy option for the treatment of early- and mid-stage HCCs, but the high heterogeneity of HCC renders prognostic prediction challenging. The construction of relevant prognostic models helps to stratify the prognosis of surgically treated patients and guide personalized clinical decision-making, thereby improving patient survival rates. Currently, the prognostic assessment of HCC is based on several commonly used staging systems, such as Tumor-Node-Metastasis (TNM), Cancer of the Liver Italian Program (CLIP), and Barcelona Clinic Liver Cancer (BCLC). Given the insufficiency of these staging systems and the aim to improve the accuracy of prognostic prediction, researchers have incorporated further prognostic factors, such as microvascular infiltration, and proposed some new prognostic models for HCC. To provide insights into the prospects of clinical oncology research, this review describes the commonly used HCC staging systems and new models proposed in recent years.

肝细胞癌(HCC)是全球最常见的恶性肿瘤之一,同时也是癌症相关死亡的主要原因之一。对于肝癌,尤其是早期和中期肝癌,外科手术是首选同时也是最有效的治疗方法。但HCC的高度异质性,给其患者的预后带来了巨大的挑战。预后模型的构建将有助于对手术治疗患者进行预后分层,并指导临床医生采取个体化治疗,从而提高患者的生存率。目前,HCC的预后评估主要基于几种常用的HCC分期系统(如TNM分期、意大利肝癌计划评分(CLIP)和巴塞罗那分期(BCLC))。然而,鉴于这些分期系统存在的不足,也为了提高预后预测的准确性,研究人员进一步纳入患者的其他预后因素,如微血管浸润,并提出了一些新的预后模型。本综述就当前常见的肝癌临床分期系统及近年提出的新预后模型进行阐述,以期为今后的临床研究提供思路。.

肝细胞癌(HCC)是全球最常见的恶性肿瘤之一,同时也是癌症相关死亡的主要原因之一。对于肝癌,尤其是早期和中期肝癌,外科手术是首选同时也是最有效的治疗方法。但HCC的高度异质性,给其患者的预后带来了巨大的挑战。预后模型的构建将有助于对手术治疗患者进行预后分层,并指导临床医生采取个体化治疗,从而提高患者的生存率。目前,HCC的预后评估主要基于几种常用的HCC分期系统(如TNM分期、意大利肝癌计划评分(CLIP)和巴塞罗那分期(BCLC))。然而,鉴于这些分期系统存在的不足,也为了提高预后预测的准确性,研究人员进一步纳入患者的其他预后因素,如微血管浸润,并提出了一些新的预后模型。本综述就当前常见的肝癌临床分期系统及近年提出的新预后模型进行阐述,以期为今后的临床研究提供思路。

Keywords: Barcelona Clinic Liver Cancer (BCLC); Clinical stage; Hepatocellular carcinoma; Nomogram; Tumor-Node-Metastasis (TNM).

Publication types

  • Review

MeSH terms

  • Carcinoma, Hepatocellular* / pathology
  • Humans
  • Liver Neoplasms* / pathology
  • Neoplasm Staging
  • Prognosis
  • Retrospective Studies
  • Survival Rate