%0 Journal Article
%T The value of the Barcelona Clinic Liver Cancer and alpha-fetoprotein in the prognosis of hepatocellular carcinoma Valor pron車stico del sistema de estadificaci車n "Barcelona Clinic Liver Cancer" y la alfa-fetoprote赤na en el carcinoma hepatocelular
%A Rafael G車mez-Rodr赤guez
%A Marta Romero-Guti谷rrez
%A Tom芍s Artaza-Varasa
%A Concepci車n Gonz芍lez-Frutos
%J Revista Espaˋola de Enfermedades Digestivas
%D 2012
%I The Spanish Society of Digestive Pathology
%X Introduction and objectives: presently, the reference staging system to evaluate the prognosis of hepatocellular carcinoma (HCC) patients is "The Barcelona Clinic Liver Cancer" (BCLC) system. The value of alpha-fetoprotein (AFP) has not been properly defined. The aim of this study was to evaluate the BCLC classification in our clinical practice and to know what the prognostic value of AFP is. Material and methods: 136 consecutive HCC patients were prospectively included in this study. The diagnosis of HCC was based on the recommendation of international guidelines. The patients were studied and managed according to usual clinical practice. Survival curves were estimated using the Kaplan-Meier method and predictors of survival were identified using the Cox model. Results: 110 patients (80.9%) were male. The mean age of the patients was 66.62 ㊣ 11.68 years. Liver cirrhosis was present in 91.2%. The most frequent cause of liver disease was hepatitis C infection (38.97%). Serum AFP was ≒ 20 ng/mL in the 57%, > 20-200 ng/mL in the 20%, and > 200 ng/mL in 23%. According to the BCLC staging system, 79 patients were classified as stage A (58.09%), 29 (21.32%) stage B, 17 (12.50%) stage C and 11 patients (8.09%) as stage D. The overall median survival time was 26.52 months (95% CI 16.7-36.3). The median survival according to BCLC system was: BCLC A 62.27, BCLC B 12.72, BCLC C 4.83, and BCLC D 0.62 months (p < 0.0001); and according to serum AFP was: AFP ≒ 20: 62.27 months, > 20-200: 22.08 months, and > 200 ng/mL: 5.39 months (p < 0.0001). Multivariate analysis showed that AFP, BCLC classification and treatment were independent prognostic factors. Conclusions: our results confirm that the BCLC is a good prognostic system. The AFP has prognosis value in HCC patients. The addition of AFP could improve the BCLC system. Future studies are needed to confirm our results and also the best way to combine BCLC and AFP properly. Introducci車n y objetivos: actualmente, el sistema de estadificaci車n de referencia para evaluar el pron車stico de los pacientes con carcinoma hepatocelular (CHC) es el "Barcelona Clinic Liver Cancer" (BCLC). El valor pron車stico de la alfa-fetoprote赤na (AFP) no ha sido claramente definido. El objetivo de este estudio fue evaluar el valor del sistema BCLC en nuestra pr芍ctica cl赤nica y conocer cu芍l es el valor pron車stico de la AFP. Material y m谷todos: se incluyeron de forma prospectiva 136 pacientes con CHC. Los pacientes fueron diagnosticados de CHC por los criterios de las gu赤as internacionales. El seguimiento y manejo terap谷utico se realiz車 seg迆n la p
%K Carcinoma hepatocelular
%K Estadificaci車n BCLC
%K Alfa-fetoprote赤na
%K Hepatocellular carcinoma
%K BCLC staging
%K Alpha-fetoprotein
%U http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S1130-01082012000600003