Schoeniger-Hekele et al developed a staging system for hepatocellular carcinoma. The stage correlates with cumulative survival and the need for more aggressive management. The authors are from the University of Vienna.
Patient selection: hepatocellular carcinoma
Parameters:
(1) serum total bilirubin in mg/dL
(2) prothrombin time as percent activity
(3) serum AFP in kU/L (units per mL)
(4) tumor volume relative to liver volume (from CT scans)
(5) portal vein thrombosis
(6) lymph nodes
Parameter
Findings
Points
serum total bilirubin
<= 2 mg/dL
0
> 2 mg/dL
1
prothrombin time
> 70%
0
<= 70%
1
serum AFP
<= 125 kU/L
0
> 125 kU/L
1
tumor size
<= 50% of liver volume
0
> 50%
1
portal vein thrombosis
no
0
yes
1
lymph nodes
not enlarged
0
enlarged (> 1 cm)
1
total score =
= SUM(points for all 6 parameters)
Interpretation:
• minimum score: 0
• maximum score: 6
• The higher the score the greater the stage and the worse the prognosis.
Total Score
Stage
Median Survival
<= 2
1
15.2 months
3
2
7.9 months
>= 4
3
3.5 months
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