Staging of hepatocellular carcinoma

Abstract

Hepatocellular carcinoma (HCC) is the third leading cause of cancer deaths in the world. In contrast to other cancers, survival of patients with HCC is determined by the extent of the tumor in addition to underlying liver disease and its functional reserve. From risk factors to management, HCC reveals a considerable geographic and institutional variation throughout the world. Although many staging and/or scoring systems have been proposed, each prognostic system has several benefits and limitations on its own. Therefore, there is currently no globally accepted system for HCC due to the extreme heterogeneity of the disease. In this review, currently available staging systems for assessing the prognosis of HCC, their uses, limitations, and future prospects are revisited.

Systematic review and meta-analysis of validated prognostic models for resected hepatocellular carcinoma patients

“…Several other reviews of prognostic models for HCC have been published. [4][5][6][7][8] These reviews, however, were qualitative in nature, did not require external validation, and did not perform meta-analysis for model performance (c-indices).…”

“…They conclude that there is no ideal staging system accounting for the geographical and etiological differences [4,5]. Most reviews conclude that the BCLC is the most comprehensive and commonly used staging system.…”

“…Several literature overviews of prognostic models for HCC have been published [4][5][6][7][8]. These reviews broadly discuss the historical context and classification schemes of the most common staging systems.…”

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“…186 Küçük Buzul Çağı'na bağlı olarak aşırı soğuklar Osmanlı ordusunu da olumsuz şekilde etkilemiştir. 187 1594 yılının sonlarında hava durumunun değişikliğiyle sıkıntılar hızla artmıştır. Tarih-i Peçevi, Tarih-i Naîmâ ve Tarih-i Selânikî gibi kaynaklara göre, kış alışılmamış ölçüde sertleşirken, Yeniçeriler kıtlıktan şikayet etmeye başlamışlardı.…”

“…1605 yılının sonunda, Osmanlılar hem Avrupa hem İran hem de Anadolu'da toplam üç cephede birden çarpışıyorlardı 186. Küçük Buzul Çağı'na bağlı olarak aşırı soğuklar Osmanlı ordusunu da olumsuz şekilde etkilemiştir 187. 1594 yılının sonlarında hava durumunun değişikliğiyle sıkıntılar hızla artmıştır.…”