Optimizing stage of single large hepatocellular carcinoma: A study with subgroup analysis by tumor diameter. Issue 15 (April 2017) - Zhong, Jian-Hong
Abstract : Abstract: This study aims to refine the designation for single hepatocellular carcinoma (HCC) >5 cm by comparing the postresection prognosis of these patients with those who have a single-tumor ⩽5 cm and those with stage B. Patients with a single-tumor were classified into subgroups based on diameter. Of the 1132 patients analyzed, 426 had a single-tumor >2 and ⩽5 cm; 229, a single-tumor >5 and ⩽8 cm; 52, a single-tumor >8 and < 10 cm; 150, a single-tumor ≥10 cm; and 275, stage B. Hospital mortality and complications increased with tumor size among the single-tumor subgroups and median survival decreased with increasing of tumor size. Overall survival (OS) among patients with a single-tumor >5 cm was significantly lower than among patients with a single-tumor >2 and ⩽5 cm ( P ⩽ .001), but significantly higher than among patients with clearly stage B ( P ⩽ .001). Patients with a single-tumor >5 and ⩽8 cm showed lower OS than patients with a single-tumor >2 and ⩽5 cm ( P < .001). Patients with a single-tumor >8 and <10 cm or a single-tumor ≥10 cm showed lower OS than patients with a single-tumor >5 and ⩽8 cm ( P = .033 and .006), and similar OS to patients with stage B ( P = .323). Patients with a single-tumor >5 and ⩽8 cm may be assigned to a new stage between early and intermediate. Patients with a single-tumor >8 cm may be assigned to intermediate stage.