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. 2020 Dec;122(8):1587-1594.
doi: 10.1002/jso.26183. Epub 2020 Aug 19.

Liver resection of hepatocellular carcinoma within and beyond the Barcelona Clinic Liver Cancer guideline recommendations: Results from a high-volume liver surgery center in East Asia

Yueh-Wei Liu  1 , Chee-Chien Yong  1 , Chih-Che Lin  1 , Chih-Chi Wang  1 , Chao-Long Chen  1 , Yu-Fan Cheng  2 , Jing-Houng Wang  3 , Yi-Hao Yen  3 , Chien-Hung Chen  3
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Liver resection of hepatocellular carcinoma within and beyond the Barcelona Clinic Liver Cancer guideline recommendations: Results from a high-volume liver surgery center in East Asia

Yueh-Wei Liu et al. J Surg Oncol. 2020 Dec.

Abstract

Background: The Barcelona Clinic Liver Cancer (BCLC) guidelines were updated in 2012, and a single large hepatocellular carcinoma (HCC) more than 5 cm was regarded as BCLC stage A rather than B in the updated version. In this study, we sought to re-evaluate the outcomes of patients with HCC who underwent liver resection (LR) within (stage 0 and A) and beyond (stage B and C) the BCLC guideline recommendations of the updated BCLC staging system.

Methods: This retrospective study enrolled 774 consecutive patients with naïve HCC who underwent LR from 2011 to 2018 at our institution. The overall survival (OS) and recurrence-free survival (RFS) of these patients were examined.

Results: Of the patients, 606 had BCLC stage 0 or A HCC, and 168 had BCLC stage B or C HCC. The 5-year OS and RFS among the patients within the BCLC criteria for LR were 75.2% and 56.1%, respectively, vs 54.9% and 34.0%, respectively, among the patients beyond the BCLC criteria (P < .001). Alpha-fetoprotein more than 400 ng/mL (hazard ratio = 2.06, 95% confidence interval, 1.31-3.26, P = .002) was the only independent variable associated with recurrence among the patients beyond the BCLC criteria.

Conclusions: LR provided acceptable outcomes among selected patients with BCLC stage B and C HCC.

Keywords: Barcelona Clinic Liver Cancer; hepatocellular carcinoma; liver resection.

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References

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