New prognosis indexes specific to Barcelona Clinic Liver Cancer stage B hepatocellular carcinoma combining functional hepatic reserve and tumor burden.
- 1Department of Gastroenterology and Neurology, Faculty of Medicine, Kagawa University, Takamatsu 760-8521, Japan.
- 2Department of Gastroenterological Surgery, Faculty of Medicine, Kagawa University, Takamatsu 760-8521, Japan.
- 3Department of Medical Technology, Kagawa Prefectural University of Health Sciences, Takamatsu 761-0123, Japan.
Abstract
Background
Patients with Barcelona Clinic Liver Cancer stage B (BCLC-B) hepatocellular carcinoma (HCC) are characterized by heterogeneity in functional hepatic reserve and tumor burden. Conventional prognosis indexes are not specific to this stage. This study aimed to establish novel prognosis indexes that integrated functional hepatic reserve and tumor burden in patients with BCLC-B HCC.Methods
A total of 1843 patients with BCLC-B HCC were retrospectively enrolled from 4 hospitals. The primary endpoint was overall survival. Tumor burden was quantified as the biproduct or sum of the maximum diameter and the number of tumor nodules that is referred to as mMDN and mUS. Functional hepatic reserve was described using the albumin-bilirubin (ALBI) score.Results
Multivariate analysis demonstrated that functional hepatic reserve and tumor burden were significantly associated with overall survival. Novel prognosis indexes, termed mMDN/ALBI and mUS/ALBI, were generated by dividing mMDN and mUS by the absolute value of the ALBI score. The mMDN/ALBI and mUS/ALBI models demonstrated superior prognostic stratification of overall survival compared with the ALBI and Tokyo scores, as reflected by higher log-rank trend chi-square statistics and C-index values. Time-dependent ROC and decision curve analyses further supported their superior predictive performance and clinical utility. mMDN/ALBI ≥ 8.2 indicated poor overall survival with a median survival time of 12 to 14 months whether functional hepatic reserve was preserved or not. mUS/ALBI ≥ 5.6 also suggested the median survival time of 9 to 12 months.Conclusion
The novel prognosis indexes stratified overall survival more clearly compared to the ALBI score and Tokyo score. These indexes enable more accurate prognosis prediction for patients with BCLC-B HCC.
Related
- Atezolizumab Plus Bevacizumab Treatment for Patients With Hepatocellular Carcinoma in the Barcelona Clinic Liver Cancer B2 Stage
- A glycolysis-associated four-gene risk model for prognosis and immune microenvironment characterization in hepatocellular carcinoma
- Atezolizumab plus Bevacizumab with or without Transarterial Chemoembolization as First-Line Treatment for Barcelona Clinic Liver Cancer Stage C Hepatocellular Carcinoma: A Nationwide Multicenter Retrospective Study.
- Prediction of Long‐Term Prognosis in Patients With Hepatocellular Carcinoma Using the National Clinical Database Risk Calculator
- Construction of a liver hepatocellular carcinoma risk model based on fumarate metabolism-associated genes to predict prognosis and immunological landscape.
BibTeX
@article{fujita2026prognosis,
title = {{New prognosis indexes specific to Barcelona Clinic Liver Cancer stage B hepatocellular carcinoma combining functional hepatic reserve and tumor burden.}},
author = {Koji Fujita and Rie Yano and Mai Nakahara and Kyoko Oura and Hironobu Suto and Asahiro Morishita and Takashi Himoto and Keiichi Okano and Hideki Kobara},
journal = {The oncologist},
year = {2026},
month = oct,
doi = {10.1093/oncolo/oyag392},
url = {https://europepmc.org/article/MED/42832300},
note = {CC BY},
}
RIS
TY - JOUR
TI - New prognosis indexes specific to Barcelona Clinic Liver Cancer stage B hepatocellular carcinoma combining functional hepatic reserve and tumor burden.
AU - Koji Fujita
AU - Rie Yano
AU - Mai Nakahara
AU - Kyoko Oura
AU - Hironobu Suto
AU - Asahiro Morishita
AU - Takashi Himoto
AU - Keiichi Okano
AU - Hideki Kobara
PY - 2026
DA - 2026/10/01
JO - The oncologist
DO - 10.1093/oncolo/oyag392
UR - https://europepmc.org/article/MED/42832300
AB - Background Patients with Barcelona Clinic Liver Cancer stage B (BCLC-B) hepatocellular carcinoma (HCC) are characterized by heterogeneity in functional hepatic reserve and tumor burden. Conventional prognosis indexes are not specific to this stage. This study aimed to establish novel prognosis indexes that integrated functional hepatic reserve and tumor burden in patients with BCLC-B HCC.Methods A total of 1843 patients with BCLC-B HCC were retrospectively enrolled from 4 hospitals. The primary endpoint was overall survival. Tumor burden was quantified as the biproduct or sum of the maximum diameter and the number of tumor nodules that is referred to as mMDN and mUS. Functional hepatic reserve was described using the albumin-bilirubin (ALBI) score.Results Multivariate analysis demonstrated that functional hepatic reserve and tumor burden were significantly associated with overall survival. Novel prognosis indexes, termed mMDN/ALBI and mUS/ALBI, were generated by dividing mMDN and mUS by the absolute value of the ALBI score. The mMDN/ALBI and mUS/ALBI models demonstrated superior prognostic stratification of overall survival compared with the ALBI and Tokyo scores, as reflected by higher log-rank trend chi-square statistics and C-index values. Time-dependent ROC and decision curve analyses further supported their superior predictive performance and clinical utility. mMDN/ALBI ≥ 8.2 indicated poor overall survival with a median survival time of 12 to 14 months whether functional hepatic reserve was preserved or not. mUS/ALBI ≥ 5.6 also suggested the median survival time of 9 to 12 months.Conclusion The novel prognosis indexes stratified overall survival more clearly compared to the ALBI score and Tokyo score. These indexes enable more accurate prognosis prediction for patients with BCLC-B HCC.
SN - 1083-7159
SN - 1549-490X
ER -