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. 2016 Apr 19:16:22.
doi: 10.1186/s12893-016-0135-4.

Combined measurements of tumor number and size helps estimate the outcome of resection of Barcelona clinic liver cancer stage B hepatocellular carcinoma

Xin Wang  1 , Zusen Wang  1 , Liqun Wu  2   3
Affiliations

Combined measurements of tumor number and size helps estimate the outcome of resection of Barcelona clinic liver cancer stage B hepatocellular carcinoma

Xin Wang et al. BMC Surg. .

Abstract

Background: Although the Barcelona Clinic Liver Cancer (BCLC) staging system suggests that patients with stage B hepatocellular carcinoma (HCC) should be treated with transcatheter arterial chemoembolization instead of surgical treatment, recent studies indicated that the prognosis of surgical resection for patients with BCLC stage B HCC was better than that of TACE. However, the portion of patients with stage B that will achieve better outcomes from surgical treatment remains unclear. In this study, we identified risk factors that influence the prognosis of BCLC stage B HCC after R0 surgical resection to determine whether some patients with stage B HCC may benefit more from R0 resection than other patients and to provide a guideline to estimate the tendency.

Methods: The clinical data of 78 patients with BCLC stage B HCC after R0 surgical treatment within 11 years were analyzed retrospectively, using relapse or death as the endpoint. Kaplan-Meier survival and Cox regression analyses were used to study prognosis (disease-free survival, DFS and overall survival, OS) and independent risk factors.

Results: For all stage B patients, 1-, 2-, and 5-year DFS rates were 62.5, 36.4, and 16.6%, respectively. Cumulative tumor size >5.0 cm and tumor number ≥4 were independent prognostic risk factors for DFS. The 1-, 2-, and 5- year DFS rates and OS rates of patients with at least one of these two factors were 49.0, 17.2, and 7.4% (for DFS), and 78.6, 54.8, and 13.4% (for OS), respectively, which were significantly lower than patients without these two factors (77.8, 58.3, and 27.2% for DFS, and 94.4, 83.3,and 51.8% for OS, respectively, P < 0.01).

Conclusions: The analyses indicated that the outcomes of R0 resection were much better for patients with BCLC stage B HCC with two or three tumors and cumulative tumor sizes of ≤5.0 but >3.0 cm than other patients with stage B.

Keywords: BCLC staging; Hepatocellular carcinoma; Prognosis; R0 surgical treatment; Risk factors.

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Figures

Fig. 1
Fig. 1
ROC curves of tumor number and recurrence
Fig. 2
Fig. 2
Disease-free survival (DFS) curves of tumor number ≤3 and ≥4. The upper curve represents DFS of patients with ≤3 tumors, while the lower curve represents DFS of patients with ≥4 tumors
Fig. 3
Fig. 3
Disease-free survival (DFS) curves of cumulative tumor size ≤5 cm and >5 cm. The upper curve represents DFS of patients with a cumulative tumor size of ≤5.0 cm, while the lower curve represents DFS of patients with a cumulative tumor size >5.0 cm
Fig. 4
Fig. 4
Disease-free survival (DFS) and overall survival (OS) curves of high-risk and non-high-risk group. The upper curves represent the DFS and OS of the non-high-risk group, while the lower curves are DFS and OS of the high-risk group
See this image and copyright information in PMC

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