Prognosis of early-stage hepatocellular carcinoma: The clinical implications of substages of Barcelona Clinic Liver Cancer system based on a cohort of 1265 patients

Wei Yu Kao, Yee Chao, Chun-Chao Chang, Chung Pin Li, Chien Wei Su, Teh Ia Huo, Yi Hsiang Huang, Yu Jia Chang, Han Chieh Lin, Jaw Ching Wu

Research output: Contribution to journalArticle

20 Citations (Scopus)

Abstract

The prognostic implication of Barcelona Clinic Liver Cancer (BCLC) substages in Asian patients with hepatocellular carcinoma (HCC) is still obscure. The aim to this study is to compare the prognoses among HCC patients in different substages of the BCLC stage 0 and A. We enrolled 1265 treatment-naive HCC patients with BCLC stage 0 or A from 2007 to 2014. Factors in terms of prognoses were analyzed by multivariate analysis. There were 184, 446, 271, 92, and 272 patients in substage 0, A1, A2, A3, and A4, respectively. After a median follow-up period of 21.0 months, patients in stages 0 and A1 had comparable prognoses (P = 0.136). Both of them had significantly higher overall survival rates than those in stages A2-A4 (all P <0.001). Multivariate analysis revealed that the factors associated with mortality were serum albumin ≤3.5 g/dL (hazardratio [HR] 1.459), alpha-fetoprotein >20ng/mL (HR 1.863), tumor size >3 cm (HR 1.542), BCLC stage A2-A4 (HR 1.488), and treatment modality. Surgical resection had the highest overall survival rate followed by radiofrequency ablation (RFA) (HR 1.598), transarterial chemoembolization (HR 2.224), and other treatments (HR 3.707). Verus patients receiving RFA, those who underwent resection had a higher overall survival rate and lower recurrence rate especially in BCLC stages A2-A4. The BCLC-staging system provided good prognostic stratification for early-stage HCC. Patients with a single tumor >2 cm but without portal hypertension or jaundice had similar prognosis to those in BCLC stage 0. Curative therapies-especially hepatic resection-are suggested in early-stage HCC.

Original languageEnglish
Article numbere1929
JournalMedicine (United States)
Volume94
Issue number43
DOIs
Publication statusPublished - 2015

Fingerprint

Liver Neoplasms
Hepatocellular Carcinoma
varespladib methyl
Survival Rate
Neoplasm Staging
Portal Hypertension
Therapeutics
Jaundice
Neoplasms
Multivariate Analysis
Recurrence
Liver

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Prognosis of early-stage hepatocellular carcinoma : The clinical implications of substages of Barcelona Clinic Liver Cancer system based on a cohort of 1265 patients. / Kao, Wei Yu; Chao, Yee; Chang, Chun-Chao; Li, Chung Pin; Su, Chien Wei; Huo, Teh Ia; Huang, Yi Hsiang; Chang, Yu Jia; Lin, Han Chieh; Wu, Jaw Ching.

In: Medicine (United States), Vol. 94, No. 43, e1929, 2015.

Research output: Contribution to journalArticle

@article{ee62f13b99ee4c379e44523d3703a5a8,
title = "Prognosis of early-stage hepatocellular carcinoma: The clinical implications of substages of Barcelona Clinic Liver Cancer system based on a cohort of 1265 patients",
abstract = "The prognostic implication of Barcelona Clinic Liver Cancer (BCLC) substages in Asian patients with hepatocellular carcinoma (HCC) is still obscure. The aim to this study is to compare the prognoses among HCC patients in different substages of the BCLC stage 0 and A. We enrolled 1265 treatment-naive HCC patients with BCLC stage 0 or A from 2007 to 2014. Factors in terms of prognoses were analyzed by multivariate analysis. There were 184, 446, 271, 92, and 272 patients in substage 0, A1, A2, A3, and A4, respectively. After a median follow-up period of 21.0 months, patients in stages 0 and A1 had comparable prognoses (P = 0.136). Both of them had significantly higher overall survival rates than those in stages A2-A4 (all P <0.001). Multivariate analysis revealed that the factors associated with mortality were serum albumin ≤3.5 g/dL (hazardratio [HR] 1.459), alpha-fetoprotein >20ng/mL (HR 1.863), tumor size >3 cm (HR 1.542), BCLC stage A2-A4 (HR 1.488), and treatment modality. Surgical resection had the highest overall survival rate followed by radiofrequency ablation (RFA) (HR 1.598), transarterial chemoembolization (HR 2.224), and other treatments (HR 3.707). Verus patients receiving RFA, those who underwent resection had a higher overall survival rate and lower recurrence rate especially in BCLC stages A2-A4. The BCLC-staging system provided good prognostic stratification for early-stage HCC. Patients with a single tumor >2 cm but without portal hypertension or jaundice had similar prognosis to those in BCLC stage 0. Curative therapies-especially hepatic resection-are suggested in early-stage HCC.",
author = "Kao, {Wei Yu} and Yee Chao and Chun-Chao Chang and Li, {Chung Pin} and Su, {Chien Wei} and Huo, {Teh Ia} and Huang, {Yi Hsiang} and Chang, {Yu Jia} and Lin, {Han Chieh} and Wu, {Jaw Ching}",
year = "2015",
doi = "10.1097/MD.0000000000001929",
language = "English",
volume = "94",
journal = "Medicine; analytical reviews of general medicine, neurology, psychiatry, dermatology, and pediatries",
issn = "0025-7974",
publisher = "Lippincott Williams and Wilkins",
number = "43",

}

TY - JOUR

T1 - Prognosis of early-stage hepatocellular carcinoma

T2 - The clinical implications of substages of Barcelona Clinic Liver Cancer system based on a cohort of 1265 patients

AU - Kao, Wei Yu

AU - Chao, Yee

AU - Chang, Chun-Chao

AU - Li, Chung Pin

AU - Su, Chien Wei

AU - Huo, Teh Ia

AU - Huang, Yi Hsiang

AU - Chang, Yu Jia

AU - Lin, Han Chieh

AU - Wu, Jaw Ching

PY - 2015

Y1 - 2015

N2 - The prognostic implication of Barcelona Clinic Liver Cancer (BCLC) substages in Asian patients with hepatocellular carcinoma (HCC) is still obscure. The aim to this study is to compare the prognoses among HCC patients in different substages of the BCLC stage 0 and A. We enrolled 1265 treatment-naive HCC patients with BCLC stage 0 or A from 2007 to 2014. Factors in terms of prognoses were analyzed by multivariate analysis. There were 184, 446, 271, 92, and 272 patients in substage 0, A1, A2, A3, and A4, respectively. After a median follow-up period of 21.0 months, patients in stages 0 and A1 had comparable prognoses (P = 0.136). Both of them had significantly higher overall survival rates than those in stages A2-A4 (all P <0.001). Multivariate analysis revealed that the factors associated with mortality were serum albumin ≤3.5 g/dL (hazardratio [HR] 1.459), alpha-fetoprotein >20ng/mL (HR 1.863), tumor size >3 cm (HR 1.542), BCLC stage A2-A4 (HR 1.488), and treatment modality. Surgical resection had the highest overall survival rate followed by radiofrequency ablation (RFA) (HR 1.598), transarterial chemoembolization (HR 2.224), and other treatments (HR 3.707). Verus patients receiving RFA, those who underwent resection had a higher overall survival rate and lower recurrence rate especially in BCLC stages A2-A4. The BCLC-staging system provided good prognostic stratification for early-stage HCC. Patients with a single tumor >2 cm but without portal hypertension or jaundice had similar prognosis to those in BCLC stage 0. Curative therapies-especially hepatic resection-are suggested in early-stage HCC.

AB - The prognostic implication of Barcelona Clinic Liver Cancer (BCLC) substages in Asian patients with hepatocellular carcinoma (HCC) is still obscure. The aim to this study is to compare the prognoses among HCC patients in different substages of the BCLC stage 0 and A. We enrolled 1265 treatment-naive HCC patients with BCLC stage 0 or A from 2007 to 2014. Factors in terms of prognoses were analyzed by multivariate analysis. There were 184, 446, 271, 92, and 272 patients in substage 0, A1, A2, A3, and A4, respectively. After a median follow-up period of 21.0 months, patients in stages 0 and A1 had comparable prognoses (P = 0.136). Both of them had significantly higher overall survival rates than those in stages A2-A4 (all P <0.001). Multivariate analysis revealed that the factors associated with mortality were serum albumin ≤3.5 g/dL (hazardratio [HR] 1.459), alpha-fetoprotein >20ng/mL (HR 1.863), tumor size >3 cm (HR 1.542), BCLC stage A2-A4 (HR 1.488), and treatment modality. Surgical resection had the highest overall survival rate followed by radiofrequency ablation (RFA) (HR 1.598), transarterial chemoembolization (HR 2.224), and other treatments (HR 3.707). Verus patients receiving RFA, those who underwent resection had a higher overall survival rate and lower recurrence rate especially in BCLC stages A2-A4. The BCLC-staging system provided good prognostic stratification for early-stage HCC. Patients with a single tumor >2 cm but without portal hypertension or jaundice had similar prognosis to those in BCLC stage 0. Curative therapies-especially hepatic resection-are suggested in early-stage HCC.

UR - http://www.scopus.com/inward/record.url?scp=84946560009&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84946560009&partnerID=8YFLogxK

U2 - 10.1097/MD.0000000000001929

DO - 10.1097/MD.0000000000001929

M3 - Article

C2 - 26512620

AN - SCOPUS:84946560009

VL - 94

JO - Medicine; analytical reviews of general medicine, neurology, psychiatry, dermatology, and pediatries

JF - Medicine; analytical reviews of general medicine, neurology, psychiatry, dermatology, and pediatries

SN - 0025-7974

IS - 43

M1 - e1929

ER -