Survival analysis of proposed BCLC‐B subgroups in hepatocellular carcinoma patients. (31st October 2014)

• Record Type: Journal Article
• Authors: Weinmann, Arndt; Koch, Sandra; Sprinzl, Martin; Kloeckner, Roman; Schulze‐Bergkamen, Henning; Düber, Christoph; Lang, Hauke; Otto, Gerd; Wörns, Marcus A.; Galle, Peter R.
• Is Part Of: Liver international. Volume 35:Number 2(2015:Feb.)
• Page Start: 591
• Page End: 600
• Publication Date: 2014-10-31
• Subjects: Liver -- Periodicals; Liver -- Diseases -- Periodicals; 616.362
• DOI: 10.1111/liv.12696
• Languages: English
• ISSNs: 1478-3223

Abstract

<abstract abstract-type="main" id="liv12696-abs-0001"> <title>Abstract</title> <sec id="liv12696-sec-0001" sec-type="section"> <title>Background & Aims</title> <p>The BCLC‐staging system is used to facilitate treatment decisions in patients with hepatocellular carcinoma (HCC). Owing to the observed clinical heterogeneity of the intermediate stage BCLC‐B, a subclassification was proposed taking Child–Pugh score and extended criteria for transplantation into account. Analysis of the prognostic significance of a proposed subclassification of the BCLC‐B score in a European cohort of HCC patients.</p> </sec> <sec id="liv12696-sec-0002" sec-type="section"> <title>Methods</title> <p>Eight hundred and eighty four consecutive HCC patients were retrospectively analysed. Patients with stage BCLC‐B were grouped according to the proposed subclassification. Baseline patient and tumour characteristics, therapy and overall survival were analysed.</p> </sec> <sec id="liv12696-sec-0003" sec-type="section"> <title>Results</title> <p>Two hundred and fifty four patients with stage BCLC‐B were classified as B1/B2/B3 and B4 in 16.1/56.7/7.9 and 19.3%. OS compared between adjacent subgroups (B1 vs. B2, B2 vs. B3, B3 vs. B4) did not reach statistical significance. Groupwise comparison showed significant differences between B1 vs. B3 (<italic>P</italic> = 0.035), B1 vs. B4 (<italic>P</italic> = 0.006) and B2 vs. B4 (<italic>P</italic> < 0.0001). OS was significantly improved in patients undergoing OLT (<italic>P</italic> < 0.0001). Cox regression showed no significant influence of the BCLC‐B substage on survival.</p> </sec> <sec id="liv12696-sec-0004" sec-type="section"> <title>Conclusions</title> <p>No significant survival differences between subgroups were found in the retrospective analysis. We could not confirm the BCLC‐B subclassification to be prognostically meaningful in our cohort. As liver function and therapy influenced survival in this study, a more refined BCLC‐B subclassification has the potential to be a useful tool to better stratify treatment decisions. Further studies in larger collectives with homogenous staging and treatment strategies are warranted to confirm the prognostic significance of the proposed subclassifications.</p> </sec> </abstract>