New Staging Model for Radiation-based Hepatocellular Carcinoma Treatment: A National Multicenter Study

Area of Science:

• Oncology
• Radiotherapy
• Hepatocellular Carcinoma Research

Background:

• Hepatocellular carcinoma (HCC) treatment relies on accurate prognostic staging.
• Current staging systems may not fully capture prognostic nuances for radiotherapy-based treatments.

Purpose of the Study:

• To develop and validate a novel staging model for hepatocellular carcinoma (HCC) specifically for radiotherapy-based treatment planning.
• To enhance prognostic classification and guide clinical decision-making in HCC management.

Main Methods:

• A modified staging system was established using data from a training cohort (658 patients) and validated on an external cohort (533 patients).
• The system incorporates tumor characteristics, performance status (PS), and the Albumin-Bilirubin (ALBI) grade.
• Patients were categorized into four stages (I-IV) with seven substages based on nodule number/size, macrovascular invasion, metastasis, PS, and ALBI grade.

Main Results:

• The modified staging model demonstrated excellent discrimination across four stages and seven substages in both training and validation cohorts.
• Median overall survival significantly decreased from Stage I (63.0 months) to Stage IV (<9.0 months).
• Distinct survival curves were observed between different stages and substages, highlighting the model's prognostic power.

Conclusions:

• The developed modified staging model offers a robust and validated tool for prognostic classification in hepatocellular carcinoma (HCC) patients undergoing radiotherapy.
• This model provides a valuable alternative for radiation oncologists, potentially improving treatment stratification and patient management.