J Liver Cancer.  2016 Mar;16(1):17-22. 10.17998/jlc.2016.16.1.17.

Subclassification of Hepatocellular Carcinoma with Barcelona Clinic Liver Cancer Intermediate Stage

• Lee HW
• Kim SU
• Park JY
• Kim DY
• Ahn SH
• Han KH
• Kim BK

• KMID: 2198518
• DOI: http://doi.org/10.17998/jlc.2016.16.1.17

Abstract

BACKGROUND/AIMS
Hepatocellular carcinoma (HCC) with Barcelona Clinic Liver Cancer (BCLC) intermediate stage includes a highly heterogeneous population. Here, we aimed to sub-classify hepatocellular carcinoma with BCLC intermediate stage for better prognostification.
METHODS
Between 2003 and 2008, 325 patients who were newly diagnosed as HCC with BCLC intermediate stage were considered eligible. Tumor factor and liver function were used for sub-classification. Overall survival (OS) was analyzed using Kaplan-Meier method with a comparison by log-rank test.
RESULTS
A total of 325 patients with intermediate stage HCC were analyzed. Patients with tumor size ≥7 cm, tumor number ≥4 and Child-Pugh class B had the worse OS compared to those with tumor size <7 cm, tumor number <4 and Child-pugh class A, respectively (all P<0.05). These three variables affected the OS independently from multivariate Cox regression analysis (all P<0.05). So, using these three variables, patients were finally sub-classified as those with fulfilling none of three factors (B-a), one of three factors (B-b), two of three factors (B-c) and all of three factors (B-d) with the median OS of 39.2, 20.6, 12.0 and 8.3 months with statistical significances (all P<0.05 between B-a and B-b, between B-b and B-c, and between B-c and B-d), respectively.
CONCLUSIONS
Sub-classification of HCC with BCLC intermediate stage may be useful in not only prognostification but also guidance of treatment strategies.

Keyword

Hepatocellular carcinoma; Sub-classification; Prognosis; Barcelona Clinic Liver Cancer Stage; Intermediate

MeSH Terms

Carcinoma, Hepatocellular*
Humans
Liver Neoplasms*
Liver*
Prognosis