AHPBA/AJCC consensus conference on staging of hepatocellular carcinoma: consensus statement

Abstract

Staging systems for cancer are developed with several objectives in mind [ 1 x 1 Fleming, I.D. AJCC/TNM Cancer Staging, present and future. J Surg Oncol. 2001; 77: 233–236 Crossref | PubMed | Scopus (38) | Google Scholar See all References 1 ]. First, staging subdivides patients with this naturally progressive disease into cohorts based on extent, and by inference severity of the disease, and predicts survival at each level of severity. This subdivision permits prognosis to be assigned to a cohort that matches particular staging criteria, which in turn allows reports from different centers and even different countries to be compared. Differences in stage of presentation and outcome in either treated or untreated patients from different centers can be assessed. Staging also allows investigators to decide whether particular cohorts are similar to or different from other cohorts. This objective gives each center a crude picture of how well or poorly it is doing with respect to a standard. Second, staging is used to select primary and adjuvant therapy, and to assess the outcome of therapy in a given cohort. Staging is used in the design of therapeutic trials to ensure uniformity of disease severity. It also assists in stratification of patients before randomization. Thus it is easier to be certain that differences in outcome are related to differences in therapy rather than differences in patient populations. Finally, staging is also a form of record‐keeping for registry purposes.