257P - Comparison of Four Staging Systems to Predict Overall Survival Rate in Indonesian Hepatocellular Carcinoma Patients (257P)

Date 18 November 2017
Event ESMO Asia 2017 Congress
Session Poster lunch
Topics Hepatobiliary Cancers
Gastrointestinal Cancers
Imaging, Diagnosis and Staging
Presenter Kalis Waren
Citation Annals of Oncology (2017) 28 (suppl_10): x57-x76. 10.1093/annonc/mdx660
Authors K. Waren, A.D. Vatvani, D. Widjaja, M. Leonardo, A. Kurniawan
  • Faculty Of Medicine, Pelita Harapan University, 15811 - Tangerang/ID



Hepatocellular carcinoma (HCC) is the third highest cause of cancer death worldwide. Despite early diagnosis and advancement in medical care, the overall survival rate of HCC patients in Indonesia is still low. The staging system for HCC plays a major role for predicting survival rate. There are many types of staging systems available. However, the best HCC staging system for Indonesian patients is still unknown. The aim of this study is to know the best staging system to predict the overall survival rate in Indonesian HCC patients.


This is a retrospective cohort study that took place in Siloam General Hospital located in suburban area of Tangerang, Indonesia. The data was taken from the medical records from years 2013 to 2017. We called the patients’ family for death or alive status. We compared four different types of staging systems Barcelona Clinic Liver Cancer (BCLC), Chinese University Prognostic Index (CUPI), Cancer of the Liver Italian Program (CLIP) and American Joint Committee on Cancer (AJCC)/Union Against Cancer (UICC) TNM staging systems. The baseline characteristics were presented in the form of descriptive statistics. Comparison of staging systems for survival was analyzed using Kaplan-Meier and Cox-Regression method.


A total of 52 HCC patients were included in our study. The median age of patients was 61 (34-73) years. Median BMI was 19.55 (15.60-23.80) kg/m2. Majority of patients were male (51.9%). Hepatitis B and C was the cause of HCC in 21 (40.4%) and 2 (3.8%) patients respectively. There were 35 (67.3%) patients classified as Child-Pugh class B and 5 (9.6%) patients classified as Child-Pugh class C. The overall 1,3,5,7-months survival rate were respectively 84.61%, 53.85%, 23.07% and 7.69% and the median survival rate was 4 months. In the Cox-Regression model, AJCC/UICC TNM staging system (HR = 1.422, p = 0.156) had the best prognostic ability, followed by CLIP score (HR = 1.297, p < 0.001), CUPI staging system (HR = 1.289, p < 0.001) and BCLC staging system (HR = 0.511, p = 0.031).


From all the staging systems that were statistically significant, CLIP staging system is the best for predicting overall survival in Indonesian HCC patients.

Clinical trial identification

Legal entity responsible for the study

Faculty of Medicine, Pelita Harapan University




All authors have declared no conflicts of interest.