Comparison Of Hong Kong Liver Cancer With Barcelona Clinic Liver Cancer Staging Systems In A Cohort Of Egyptian Patients With Hepatocellular Carcinoma

BackgroundAccurate staging information is necessary to determine the prognosis of patients with hepatocellular carcinoma (HCC) and to guide subsequent patient management.AimTo compare the prognostic performance of Hong Kong Liver Cancer (HKLC) staging system with Barcelona Clinic Liver Cancer (BCLC) staging system in an Egyptian cohort of HCC patients.MethodsThis was a retrospective study conducted at National Liver Institute, Menoufia University, Egypt, on 1015 HCC patients with full data recruited from our medical records during the last 10 years. BCLC and HKLC stages were determined and Kaplan-Meier survival analysis was used to compare patients‘ overall survival regarding treatment within BCLC staging system and within HKLC staging system. Performance and prognostic value of HKLC and BCLC staging systems were compared using area under the receiver operating characteristic curve (AUC).ResultsA total of 1015 patients with HCC were recruited. There was a statistically significant difference in survival between different stages of BCLC as well as different stages of HKLC staging systems. Depending on Receiver operating characteristic (ROC) curves, the discriminatory ability to predict survival at 3 years of HKLC and BCLC staging systems were nearly the same (AUC= 0.667, 0.619 respectively). Out of 459 patients at BCLC stages B and C, 123 patients were already treated beyond BCLC treatment options but matching the HKLC recommendations. Their median survival time was 14.6 months which was not inferior to the 336 patients treated according to BCLC classification with a median survival time of 12.3 months (p-value 0.001). (IDDF2021-ABS-0015 Figure 1)ConclusionsIn our study, the HKLC classification had a slightly better prognostic performance compared to the BCLC staging system and might provide a survival benefit favoring expanding the treatment options for BCLC stages B and C HCC.