BACKGROUND: The Barcelona Clinic Liver Cancer (BCLC) staging system recommends first-line therapy for each tumor stage. We evaluated the effect of compliance with BCLC treatment allocation on the prognosis of patients with hepatocellular carcinoma (HCC). METHODS: We retrospectively analyzed 359 consecutive, newly diagnosed HCC patients treated in our Liver Unit during a 14-year period. For each stage, survival was compared according to whether treatment matched the BCLC recommendation. We also compared the survival of patients in the same BCLC stage who received different treatments, and patients in different BCLC stages receiving the same treatment. RESULTS: BCLC-A patients treated with radical therapies (66%) survived longer (117 vs. 20 months; p < 0.001) than patients (33%) who received locoregional or systemic therapies. Survival of BCLC-B patients treated with locoregional treatments (57%) was shorter (24 vs. 71 months; p < 0.001) than that of patients receiving radical therapies (32%). BCLC-C patients treated with systemic therapy or supportive care survived shorter (6 vs. 11 months; p = 0.003) than those receiving locoregional therapies (39%). Survival of BCLC-D patients receiving systemic therapies or supportive care was significantly lower than that of patients treated by liver transplantation (5 vs. 137 months; p < 0.001). CONCLUSIONS: In addition to BCLC stage, actual treatment determines survival in patients with HCC.
BACKGROUND: The Barcelona Clinic Liver Cancer (BCLC) staging system recommends first-line therapy for each tumor stage. We evaluated the effect of compliance with BCLC treatment allocation on the prognosis of patients with hepatocellular carcinoma (HCC). METHODS: We retrospectively analyzed 359 consecutive, newly diagnosed HCC patients treated in our Liver Unit during a 14-year period. For each stage, survival was compared according to whether treatment matched the BCLC recommendation. We also compared the survival of patients in the same BCLC stage who received different treatments, and patients in different BCLC stages receiving the same treatment. RESULTS: BCLC-A patients treated with radical therapies (66%) survived longer (117 vs. 20 months; p < 0.001) than patients (33%) who received locoregional or systemic therapies. Survival of BCLC-B patients treated with locoregional treatments (57%) was shorter (24 vs. 71 months; p < 0.001) than that of patients receiving radical therapies (32%). BCLC-C patients treated with systemic therapy or supportive care survived shorter (6 vs. 11 months; p = 0.003) than those receiving locoregional therapies (39%). Survival of BCLC-D patients receiving systemic therapies or supportive care was significantly lower than that of patients treated by liver transplantation (5 vs. 137 months; p < 0.001). CONCLUSIONS: In addition to BCLC stage, actual treatment determines survival in patients with HCC.
Authors: Khairuddin Memon; Laura M Kulik; Robert J Lewandowski; Edward Wang; Jonathan Wang; Robert K Ryu; Ryan Hickey; Michael Vouche; Talia Baker; Daniel Ganger; Vanessa L Gates; Ali Habib; Mary F Mulcahy; Riad Salem Journal: J Vasc Interv Radiol Date: 2014-03-07 Impact factor: 3.464
Authors: Edith Y Ho; Myrna L Cozen; Hui Shen; Robert Lerrigo; Erica Trimble; James C Ryan; Carlos U Corvera; Alexander Monto Journal: HPB (Oxford) Date: 2014-01-28 Impact factor: 3.647
Authors: Heung Cheol Kim; Ki Tae Suk; Dong Joon Kim; Jai Hoon Yoon; Yeon Soo Kim; Gwang Ho Baik; Jin Bong Kim; Chang Hoon Kim; Hotaik Sung; Jong Young Choi; Kwang Hyub Han; Seung Ha Park Journal: World J Gastroenterol Date: 2014-01-21 Impact factor: 5.742