Survival analysis of single large (>5 cm) hepatocellular carcinoma patients: BCLC A versus B

Yuri Cho, Dong Hyun Sinn, Su Jong Yu, Geum Youn Gwak, Ji Hoon Kim, Yang Jae Yoo, Dae Won Jun, Tae Yeob Kim, Hyo Young Lee, Eun Ju Cho, Jeong Hoon Lee, Yoon Jun Kim, Jung Hwan Yoon

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Background & Aims Single large (>5 cm) hepatocellular carcinoma (HCC) is classified as Barcelona Liver Clinic (BCLC) stage early stage (A). Yet, controversies exist whether single large HCC can be considered as early stage. We have analyzed long-Term outcome to see which stage is appropriate for these patients. Methods From 2005 to 2006, 1,546 consecutive patients who were newly diagnosed as HCC (BCLC A or B) at four tertiary hospitals in Korea were analyzed. BCLC A was sub-classified into A1 (single 2×5 cm), A2 (2×3 nodules 3 cm), and A3 (single >5 cm). BCLC B1 included patients beyond-Milan criteria, and within up-To-7 criterion. Survival prediction between subgroupings (1: A1 + A2 + A3 vs. B1 and 2: A1 + A2 vs. A3 + B1) was compared based on c-index and Akaike information criterion (AIC). Results The 5-year overall survival (OS) rate was 62.3, 58.6, 36.8, and 42.0% for A1, A2, A3 and B1, respectively. In multivariate Cox-regression analysis, OS was significantly different between A3 + B1 vs. A1 + A2 (hazard ratio [HR] 1.85; P<0.001), but not between A1 + A2 + A3 vs. B1 (HR 1.19; P = 0.258). For A3, surgical resection showed superior OS over transarterial chemoembolization. Survival prediction was superior in subgrouping 2 (AIC 5727.2; cindex 0.652) than subgrouping 1 (AIC 5766.3; c-index 0.619) even after inverse probability weighting. Conclusions This large scale long-Term follow-up data shows that single large tumor should be considered as intermediate stage in terms of prognosis. However, in terms of treatment, resection might be the first line treatment option.

Original languageEnglish
Article number0165722
JournalPLoS One
Volume11
Issue number11
DOIs
Publication statusPublished - 2016 Nov 1

Fingerprint

hepatoma
Survival Analysis
varespladib methyl
Liver
Hepatocellular Carcinoma
liver
resection
Hazards
Survival
prediction
Regression analysis
prognosis
Korean Peninsula
Tumors
regression analysis
survival rate
Korea
Tertiary Care Centers
neoplasms
Survival Rate

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)

Cite this

Cho, Y., Sinn, D. H., Yu, S. J., Gwak, G. Y., Kim, J. H., Yoo, Y. J., ... Yoon, J. H. (2016). Survival analysis of single large (>5 cm) hepatocellular carcinoma patients: BCLC A versus B. PLoS One, 11(11), [0165722]. https://doi.org/10.1371/journal.pone.0165722

Survival analysis of single large (>5 cm) hepatocellular carcinoma patients : BCLC A versus B. / Cho, Yuri; Sinn, Dong Hyun; Yu, Su Jong; Gwak, Geum Youn; Kim, Ji Hoon; Yoo, Yang Jae; Jun, Dae Won; Kim, Tae Yeob; Lee, Hyo Young; Cho, Eun Ju; Lee, Jeong Hoon; Kim, Yoon Jun; Yoon, Jung Hwan.

In: PLoS One, Vol. 11, No. 11, 0165722, 01.11.2016.

Research output: Contribution to journalArticle

Cho, Y, Sinn, DH, Yu, SJ, Gwak, GY, Kim, JH, Yoo, YJ, Jun, DW, Kim, TY, Lee, HY, Cho, EJ, Lee, JH, Kim, YJ & Yoon, JH 2016, 'Survival analysis of single large (>5 cm) hepatocellular carcinoma patients: BCLC A versus B', PLoS One, vol. 11, no. 11, 0165722. https://doi.org/10.1371/journal.pone.0165722
Cho, Yuri ; Sinn, Dong Hyun ; Yu, Su Jong ; Gwak, Geum Youn ; Kim, Ji Hoon ; Yoo, Yang Jae ; Jun, Dae Won ; Kim, Tae Yeob ; Lee, Hyo Young ; Cho, Eun Ju ; Lee, Jeong Hoon ; Kim, Yoon Jun ; Yoon, Jung Hwan. / Survival analysis of single large (>5 cm) hepatocellular carcinoma patients : BCLC A versus B. In: PLoS One. 2016 ; Vol. 11, No. 11.
@article{7e9a85d1c92e48a9b2dc5541e636f354,
title = "Survival analysis of single large (>5 cm) hepatocellular carcinoma patients: BCLC A versus B",
abstract = "Background & Aims Single large (>5 cm) hepatocellular carcinoma (HCC) is classified as Barcelona Liver Clinic (BCLC) stage early stage (A). Yet, controversies exist whether single large HCC can be considered as early stage. We have analyzed long-Term outcome to see which stage is appropriate for these patients. Methods From 2005 to 2006, 1,546 consecutive patients who were newly diagnosed as HCC (BCLC A or B) at four tertiary hospitals in Korea were analyzed. BCLC A was sub-classified into A1 (single 2×5 cm), A2 (2×3 nodules 3 cm), and A3 (single >5 cm). BCLC B1 included patients beyond-Milan criteria, and within up-To-7 criterion. Survival prediction between subgroupings (1: A1 + A2 + A3 vs. B1 and 2: A1 + A2 vs. A3 + B1) was compared based on c-index and Akaike information criterion (AIC). Results The 5-year overall survival (OS) rate was 62.3, 58.6, 36.8, and 42.0{\%} for A1, A2, A3 and B1, respectively. In multivariate Cox-regression analysis, OS was significantly different between A3 + B1 vs. A1 + A2 (hazard ratio [HR] 1.85; P<0.001), but not between A1 + A2 + A3 vs. B1 (HR 1.19; P = 0.258). For A3, surgical resection showed superior OS over transarterial chemoembolization. Survival prediction was superior in subgrouping 2 (AIC 5727.2; cindex 0.652) than subgrouping 1 (AIC 5766.3; c-index 0.619) even after inverse probability weighting. Conclusions This large scale long-Term follow-up data shows that single large tumor should be considered as intermediate stage in terms of prognosis. However, in terms of treatment, resection might be the first line treatment option.",
author = "Yuri Cho and Sinn, {Dong Hyun} and Yu, {Su Jong} and Gwak, {Geum Youn} and Kim, {Ji Hoon} and Yoo, {Yang Jae} and Jun, {Dae Won} and Kim, {Tae Yeob} and Lee, {Hyo Young} and Cho, {Eun Ju} and Lee, {Jeong Hoon} and Kim, {Yoon Jun} and Yoon, {Jung Hwan}",
year = "2016",
month = "11",
day = "1",
doi = "10.1371/journal.pone.0165722",
language = "English",
volume = "11",
journal = "PLoS One",
issn = "1932-6203",
publisher = "Public Library of Science",
number = "11",

}

TY - JOUR

T1 - Survival analysis of single large (>5 cm) hepatocellular carcinoma patients

T2 - BCLC A versus B

AU - Cho, Yuri

AU - Sinn, Dong Hyun

AU - Yu, Su Jong

AU - Gwak, Geum Youn

AU - Kim, Ji Hoon

AU - Yoo, Yang Jae

AU - Jun, Dae Won

AU - Kim, Tae Yeob

AU - Lee, Hyo Young

AU - Cho, Eun Ju

AU - Lee, Jeong Hoon

AU - Kim, Yoon Jun

AU - Yoon, Jung Hwan

PY - 2016/11/1

Y1 - 2016/11/1

N2 - Background & Aims Single large (>5 cm) hepatocellular carcinoma (HCC) is classified as Barcelona Liver Clinic (BCLC) stage early stage (A). Yet, controversies exist whether single large HCC can be considered as early stage. We have analyzed long-Term outcome to see which stage is appropriate for these patients. Methods From 2005 to 2006, 1,546 consecutive patients who were newly diagnosed as HCC (BCLC A or B) at four tertiary hospitals in Korea were analyzed. BCLC A was sub-classified into A1 (single 2×5 cm), A2 (2×3 nodules 3 cm), and A3 (single >5 cm). BCLC B1 included patients beyond-Milan criteria, and within up-To-7 criterion. Survival prediction between subgroupings (1: A1 + A2 + A3 vs. B1 and 2: A1 + A2 vs. A3 + B1) was compared based on c-index and Akaike information criterion (AIC). Results The 5-year overall survival (OS) rate was 62.3, 58.6, 36.8, and 42.0% for A1, A2, A3 and B1, respectively. In multivariate Cox-regression analysis, OS was significantly different between A3 + B1 vs. A1 + A2 (hazard ratio [HR] 1.85; P<0.001), but not between A1 + A2 + A3 vs. B1 (HR 1.19; P = 0.258). For A3, surgical resection showed superior OS over transarterial chemoembolization. Survival prediction was superior in subgrouping 2 (AIC 5727.2; cindex 0.652) than subgrouping 1 (AIC 5766.3; c-index 0.619) even after inverse probability weighting. Conclusions This large scale long-Term follow-up data shows that single large tumor should be considered as intermediate stage in terms of prognosis. However, in terms of treatment, resection might be the first line treatment option.

AB - Background & Aims Single large (>5 cm) hepatocellular carcinoma (HCC) is classified as Barcelona Liver Clinic (BCLC) stage early stage (A). Yet, controversies exist whether single large HCC can be considered as early stage. We have analyzed long-Term outcome to see which stage is appropriate for these patients. Methods From 2005 to 2006, 1,546 consecutive patients who were newly diagnosed as HCC (BCLC A or B) at four tertiary hospitals in Korea were analyzed. BCLC A was sub-classified into A1 (single 2×5 cm), A2 (2×3 nodules 3 cm), and A3 (single >5 cm). BCLC B1 included patients beyond-Milan criteria, and within up-To-7 criterion. Survival prediction between subgroupings (1: A1 + A2 + A3 vs. B1 and 2: A1 + A2 vs. A3 + B1) was compared based on c-index and Akaike information criterion (AIC). Results The 5-year overall survival (OS) rate was 62.3, 58.6, 36.8, and 42.0% for A1, A2, A3 and B1, respectively. In multivariate Cox-regression analysis, OS was significantly different between A3 + B1 vs. A1 + A2 (hazard ratio [HR] 1.85; P<0.001), but not between A1 + A2 + A3 vs. B1 (HR 1.19; P = 0.258). For A3, surgical resection showed superior OS over transarterial chemoembolization. Survival prediction was superior in subgrouping 2 (AIC 5727.2; cindex 0.652) than subgrouping 1 (AIC 5766.3; c-index 0.619) even after inverse probability weighting. Conclusions This large scale long-Term follow-up data shows that single large tumor should be considered as intermediate stage in terms of prognosis. However, in terms of treatment, resection might be the first line treatment option.

UR - http://www.scopus.com/inward/record.url?scp=84995680416&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84995680416&partnerID=8YFLogxK

U2 - 10.1371/journal.pone.0165722

DO - 10.1371/journal.pone.0165722

M3 - Article

C2 - 27846227

AN - SCOPUS:84995680416

VL - 11

JO - PLoS One

JF - PLoS One

SN - 1932-6203

IS - 11

M1 - 0165722

ER -