BCLC stage B is a better designation for single large hepatocellular carcinoma than BCLC stage A. Issue 2 (28th January 2016)

• Record Type: Journal Article
• Authors: 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
• Is Part Of: Journal of gastroenterology and hepatology. Volume 31:Issue 2(2016:Feb.)
• Page Start: 467
• Page End: 474
• Publication Date: 2016-01-28
• Subjects: BCLC staging system -- prognosis -- single large hepatocellular carcinoma -- treatment option; Gastroenterology -- Periodicals; Digestive organs -- Diseases -- Periodicals; Liver -- Diseases -- Periodicals; Gastroenterology -- Periodicals; Liver Diseases -- Periodicals; 616.33
• DOI: 10.1111/jgh.13152
• Languages: English
• ISSNs: 0815-9319

Abstract

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 > 5 cm) 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 ≤ 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. Results: 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. 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.