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ORIGINAL RESEARCH article

Front. Oncol.
Sec. Surgical Oncology
Volume 15 - 2025 | doi: 10.3389/fonc.2025.1450333

Validation of an Albumin-Indocyanine Green-based China Liver Cancer (ALICE-CNLC) staging system to evaluating resectable hepatocellular carcinoma patients and comparison with the Child-Pugh-based China Liver cancer (CNLC) staging system

Provisionally accepted
Minqiang Chen Minqiang Chen Chao Ren Chao Ren Mengxia Wang Mengxia Wang Min Yu Min Yu *BO Zhuang BO Zhuang Bo Wu Bo Wu *Jianxiang Jin Jianxiang Jin *Yaoqi Zhang Yaoqi Zhang *Shian Yu Shian Yu *
  • Department of Hepatobiliary and Pancreatic Surgery, Jinhua Central Hospital, Jinhua, China

The final, formatted version of the article will be published soon.

    Aim: Here, the utility of an albumin-indocyanine green-based China liver cancer (CNLC) staging system (ALICE-CNLC) as a tool for the prognostic assessment of hepatocellular carcinoma (HCC) patients was evaluated, comparing this system to the Child-Pugh score-based CNLC staging system. Methods: The cohort for this study included 331 patients with HCC who had undergone hepatectomy at Jinhua Municipal Central Hospital Medical Group in China from April 2012-June 2021 and had postoperative pathology-confirmed HCC. Kaplan-Meier survival curves were generated, with log-rank tests used to examine prognostic factors. Univariate and multivariate analyses were used for identification of outcome predictors using Cox proportional hazards regression. Results: The prediction of overall survival (OS) by the ALICE-CNLC system for patients with stage Ia disease was markedly better than that for patients with stage Ib and IIa disease (P=0.010, P=0.026), while the latter groups did not differ significantly (P=0.796). The ALICE-CNLC system predicted the 3-year recurrence free survival (RFS) rates for patients with stage Ia, Ib, and IIa disease to be 50.4%, 47.7%, and 25%, respectively, with significant differences among the groups (P=0.033, P<0.001, and P=0.043 ). These results were similar to those of the CNLC staging system.The OS and RFS did not differ significantly between the same grades of patients evaluated with the ALICE-CNLC and CNLC staging systems. Conclusion: The ALICE-CNLC and CNLC staging systems did not show significant differences in predicting the prognosis of patients with HCC who have undergone hepatectomy.

    Keywords: Albumin-Indocyanine Green, Hepatocellular Carcinoma, prognostic impact, China Liver Cancer Staging, overall survival, Recurrence free survival

    Received: 17 Jun 2024; Accepted: 28 Jan 2025.

    Copyright: © 2025 Chen, Ren, Wang, Yu, Zhuang, Wu, Jin, Zhang and Yu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Min Yu, Department of Hepatobiliary and Pancreatic Surgery, Jinhua Central Hospital, Jinhua, China
    Bo Wu, Department of Hepatobiliary and Pancreatic Surgery, Jinhua Central Hospital, Jinhua, China
    Jianxiang Jin, Department of Hepatobiliary and Pancreatic Surgery, Jinhua Central Hospital, Jinhua, China
    Yaoqi Zhang, Department of Hepatobiliary and Pancreatic Surgery, Jinhua Central Hospital, Jinhua, China
    Shian Yu, Department of Hepatobiliary and Pancreatic Surgery, Jinhua Central Hospital, Jinhua, China

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