BCLC stage B is a better designation for single large hepatocellular carcinoma than BCLC stage A

Young Kul Jung, Chang Ho Jung, Yeon Seok Seo, Ji Hoon Kim, Tae Hyung Kim, Yang Jae Yoo, Seong Hee Kang, Sun Young Yim, Sang Jun Suh, Hyonggin An, Hyung Joon Yim, Jong Eun Yeon, Kwan Soo Byun, Soon-Ho Um

Research output: Contribution to journalArticle

22 Citations (Scopus)

Abstract

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 >5cm) remains controversial. This study investigated the prognosis of patients with SLHCC. Methods: Patients with newly diagnosed HCCs (BCLC stages A or B) were classified according to tumor burden: group 1, a single nodule >2 and ≤5cm or two or three nodules ≤3cm; group 2, a single nodule >5cm; and group 3, two or three nodules >3cm or >3 nodules. Survival analysis was performed according to tumor stage, treatment type, and Child-Pugh grade. Results: A total of 1005 patients were enrolled. Age was 59.3±10.6years, 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 30.3months 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. Conclusions: 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.

Original languageEnglish
Pages (from-to)467-474
Number of pages8
JournalJournal of Gastroenterology and Hepatology (Australia)
Volume31
Issue number2
DOIs
Publication statusPublished - 2016 Feb 1

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Liver Neoplasms
Hepatocellular Carcinoma
Survival
Neoplasm Staging
Survival Analysis
Tumor Burden
Neoplasms
Multivariate Analysis
Therapeutics

Keywords

  • BCLC staging system
  • Prognosis
  • Single large hepatocellular carcinoma
  • Treatment option

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

Cite this

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, Hyonggin; Yim, Hyung Joon; Yeon, Jong Eun; Byun, Kwan Soo; Um, Soon-Ho.

In: Journal of Gastroenterology and Hepatology (Australia), Vol. 31, No. 2, 01.02.2016, p. 467-474.

Research output: Contribution to journalArticle

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title = "BCLC stage B is a better designation for single large hepatocellular carcinoma than BCLC stage A",
abstract = "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 >5cm) remains controversial. This study investigated the prognosis of patients with SLHCC. Methods: Patients with newly diagnosed HCCs (BCLC stages A or B) were classified according to tumor burden: group 1, a single nodule >2 and ≤5cm or two or three nodules ≤3cm; group 2, a single nodule >5cm; and group 3, two or three nodules >3cm or >3 nodules. Survival analysis was performed according to tumor stage, treatment type, and Child-Pugh grade. Results: A total of 1005 patients were enrolled. Age was 59.3±10.6years, 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 30.3months 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. Conclusions: 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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AU - Jung, Young Kul

AU - Jung, Chang Ho

AU - Seo, Yeon Seok

AU - Kim, Ji Hoon

AU - Kim, Tae Hyung

AU - Yoo, Yang Jae

AU - Kang, Seong Hee

AU - Yim, Sun Young

AU - Suh, Sang Jun

AU - An, Hyonggin

AU - Yim, Hyung Joon

AU - Yeon, Jong Eun

AU - Byun, Kwan Soo

AU - Um, Soon-Ho

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AB - 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 >5cm) remains controversial. This study investigated the prognosis of patients with SLHCC. Methods: Patients with newly diagnosed HCCs (BCLC stages A or B) were classified according to tumor burden: group 1, a single nodule >2 and ≤5cm or two or three nodules ≤3cm; group 2, a single nodule >5cm; and group 3, two or three nodules >3cm or >3 nodules. Survival analysis was performed according to tumor stage, treatment type, and Child-Pugh grade. Results: A total of 1005 patients were enrolled. Age was 59.3±10.6years, 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 30.3months 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. Conclusions: 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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