BCLC stage B is a better designation for single large hepatocellular carcinoma than BCLC stage A
- Jung, Young Kul; Jung, Chang Ho; Seo, Yeon Seok; Kim, Ji Hoon; Kim, Tae Hyung; Yoo, Yang Jae; Kang, Seong Hee; Yim, Sun Young; Suh, Sang Jun; An, Hyunggin; Yim, Hyung Joon; Yeon, Jong Eun; Byun, Kwan Soo; Um, Soon Ho
- Issue Date
- Blackwell Publishing Inc.
- BCLC staging system; prognosis; single large hepatocellular carcinoma; treatment option
- Journal of Gastroenterology and Hepatology, v.31, no.2, pp.467 - 474
- Journal Title
- Journal of Gastroenterology and Hepatology
- Start Page
- End Page
- Background and Aim:
Although the Barcelona Clinic Liver Cancer (BCLC) staging system is widely used for hepatocellular carcinoma (HCC) staging, the most appropriate BCLC stage designation for single large HCC (SLHCC, single nodule > 5 cm) remains controversial. This study investigated the prognosis of patients with SLHCC.
Patients with newly diagnosed HCCs (BCLC stages A or B) were classified according to tumor burden: group 1, a single nodule > 2 and ≤ 5 cm or two or three nodules ≤ 3 cm; group 2, a single nodule > 5 cm; and group 3, two or three nodules > 3 cm or > 3 nodules. Survival analysis was performed according to tumor stage, treatment type, and Child–Pugh grade.
A total of 1005 patients were enrolled. Age was 59.3 ± 10.6 years, and 788 patients (78.4%) were men. Groups 1, 2, and 3 consisted of 613 (61.0%), 124 (12.3%), and 268 (26.7%) patients, respectively. HCC treatment included resection in 202 patients (20.1%), radiofrequency ablation ± transarterial chemoembolization in 311 patients (30.9%), and transarterial chemoembolization in 492 patients (49.0%). The median survival time differed significantly according to tumor stage (75.2, 44.9, and 30.3 months in groups 1, 2, and 3, respectively; P < 0.001). Multivariate analysis showed that group 2 had significantly worse survival compared with group 1 and similar survival to group 3.
Patients in group 2 had a worse prognosis than those in group 1 and a similar prognosis to those in group 3. Our results suggest that BCLC stage B is the best stage designation for SLHCC.
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- 1. Basic Science > Department of Biostatistics > 1. Journal Articles
- 2. Clinical Science > Department of Gastroenterology and Hepatology > 1. Journal Articles
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