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, Hyunggin An, Hyung Joon Yim, Jong Eun Yeon, Kwan Soo Byun, Soon Ho Um

    Research output: Contribution to journalArticlepeer-review

    41 Citations (Scopus)


    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)
    Issue number2
    Publication statusPublished - 2016 Feb 1


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

    ASJC Scopus subject areas

    • Hepatology
    • Gastroenterology


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