Comparative prognostic performance of staging systems for hepatocellular carcinoma: Evidence from a Vietnamese cohort study

Figure 1 Kaplan-Meier survival curve representing overall survival probability in the study population. A: Total 987 patients; B: Stratified by hepatitis B virus and hepatitis C virus infection status (excluding co-infected cases). HBV: Hepatitis B virus; HCV: Hepatitis C virus.

Figure 2 Kaplan-Meier survival curve depicting 5-year overall survival probability according to seven established staging and scoring systems. A: Barcelona Clinic Liver Cancer staging system; B: Hong Kong Liver Cancer (HKLC) staging system (9-tier); C: HKLC staging system (5-tier); D: Cancer of the liver Italian Program score; E: Italian Liver Cancer (ITA.LI.CA) staging system; F: Japan Integrated staging score; G: Tokyo score for hepatocellular carcinoma; H: Model to estimate survival in ambulatory hepatocellular carcinoma patients. BCLC: Barcelona Clinic Liver Cancer; HKLC: Hong Kong Liver Cancer; CLIP: Cancer of the liver Italian Program; ITA.LI.CA: Italian Liver Cancer; JIS: Japan Integrated staging; MESIAH: Model to estimate survival in ambulatory hepatocellular carcinoma patients.

Figure 3 Comparative analyses of scoring systems using receiver operating characteristic curves and area under the curve values, with heatmap of DeLong test P values highlighting discriminatory differences. A: 12 months; B: 36 months; C: 1-year mortality; D: 3-year mortality. BCLC: Barcelona Clinic Liver Cancer; HKLC: Hong Kong Liver Cancer; CLIP: Cancer of the liver Italian program; ITA.LI.CA: Italian Liver Cancer; JIS: Japan Integrated staging; MESIAH: Model to estimate survival in ambulatory hepatocellular carcinoma patients; AUC: Area under the curve; ROC: Receiver operating characteristic.

Figure 4 Calibration plots evaluating the predictive accuracy of seven staging and scoring systems for hepatocellular carcinoma prognosis. A and B: Barcelona clinic liver cancer staging system; C and D: Hong Kong Liver Cancer (HKLC) staging system (9-tier); E and F: HKLC staging system (5-tier); G and H: Cancer of the Liver Italian Program score; I and J: Italian Liver Cancer staging system; K and L: Japan Integrated staging score; M and N: Tokyo score for hepatocellular carcinoma; O and P: Model to estimate survival in ambulatory hepatocellular carcinoma patients; A, C, E, G, I, K, M and O: At 12 months; B, D, F, H, J, L, N and P: At 36 months. BCLC: Barcelona Clinic Liver Cancer; HKLC: Hong Kong Liver Cancer; CLIP: Cancer of the Liver Italian program; ITA.LI.CA: Italian Liver Cancer; JIS: Japan Integrated staging; MESIAH: Model to estimate survival in ambulatory hepatocellular carcinoma patients.

Figure 5 Receiver operating characteristic curves showing the discriminatory ability of staging and scoring systems in predicting 1-year and 3-year mortality across hepatitis B virus, hepatitis C virus, and non-B-non-C subgroups. A and B: Hepatitis B virus subgroup 1-year mortality (A) and 3-year mortality (B); C and D: Hepatitis C virus subgroup 1-year mortality (C) and 3-year mortality (D); E and F: Non-B-non-C subgroup 1-year mortality (E) and 3-year mortality (F). BCLC: Barcelona Clinic Liver cancer; HKLC: Hong Kong Liver Cancer; CLIP: Cancer of the Liver Italian Program; ITA.LI.CA: Italian Liver Cancer; JIS: Japan Integrated staging; MESIAH: Model to estimate survival in ambulatory hepatocellular carcinoma patients; AUC: Area under the curve; ROC: Receiver operating characteristic.