Masateru Yamamoto1,2, Tsuyoshi Kobayashi3,4, Masakazu Hashimoto1,2, Shintaro Kuroda1,2, Tomokazu Kawaoka2,5, Hiroshi Aikata2,5, Kazuaki Chayama2,5, Hideki Ohdan1,2. 1. Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3, Kasumi, Minami-ku, Hiroshima City, Hiroshima, 734-8551, Japan. 2. Research Center for Hepatology and Gastroenterology, Hiroshima University, Hiroshima, Japan. 3. Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3, Kasumi, Minami-ku, Hiroshima City, Hiroshima, 734-8551, Japan. tsukoba@hiroshima-u.ac.jp. 4. Research Center for Hepatology and Gastroenterology, Hiroshima University, Hiroshima, Japan. tsukoba@hiroshima-u.ac.jp. 5. Department of Gastroenterology and Metabolism, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
Abstract
BACKGROUND: Patients diagnosed with Barcelona Clinic Liver Cancer (BCLC) intermediate stage hepatocellular carcinoma (HCC) encompass a broad clinical population. Kinki criteria subclassifications have been proposed to better predict prognoses and determine appropriate treatment strategies for these patients. This study validated the prognostic significance within the Kinki criteria substages and analyzed the role of liver resection in patients with intermediate stage HCC. METHODS: Patients with intermediate stage HCC (n = 378) were retrospectively subclassified according to the Kinki criteria (B1, n = 123; B2, n = 225; and B3, n = 30). We analyzed the overall survival (OS) and treatment methods. RESULTS: The OS was significantly different between adjacent substages. Patients in substage B1 who underwent liver resection had a significantly better prognosis than those who did not, even after propensity score matching (PSM). Patients in substage B2 who underwent liver resection had a significantly better prognosis than those who did not; however, there was no difference after PSM. There was no difference in prognosis based on treatments among patients in substage B3. CONCLUSIONS: The Kinki criteria clearly stratify patients with intermediate stage HCC by prognosis. For substage B1 HCC patients, liver resection provides a better prognosis than other treatment modalities. In patients with substage B2 and B3, an alternative approach is required.
BACKGROUND:Patients diagnosed with Barcelona Clinic Liver Cancer (BCLC) intermediate stage hepatocellular carcinoma (HCC) encompass a broad clinical population. Kinki criteria subclassifications have been proposed to better predict prognoses and determine appropriate treatment strategies for these patients. This study validated the prognostic significance within the Kinki criteria substages and analyzed the role of liver resection in patients with intermediate stage HCC. METHODS:Patients with intermediate stage HCC (n = 378) were retrospectively subclassified according to the Kinki criteria (B1, n = 123; B2, n = 225; and B3, n = 30). We analyzed the overall survival (OS) and treatment methods. RESULTS: The OS was significantly different between adjacent substages. Patients in substage B1 who underwent liver resection had a significantly better prognosis than those who did not, even after propensity score matching (PSM). Patients in substage B2 who underwent liver resection had a significantly better prognosis than those who did not; however, there was no difference after PSM. There was no difference in prognosis based on treatments among patients in substage B3. CONCLUSIONS: The Kinki criteria clearly stratify patients with intermediate stage HCC by prognosis. For substage B1 HCCpatients, liver resection provides a better prognosis than other treatment modalities. In patients with substage B2 and B3, an alternative approach is required.
Authors: Arndt Weinmann; Sandra Koch; Martin Sprinzl; Roman Kloeckner; Henning Schulze-Bergkamen; Christoph Düber; Hauke Lang; Gerd Otto; Marcus A Wörns; Peter R Galle Journal: Liver Int Date: 2014-10-31 Impact factor: 5.828
Authors: Thomas W T Leung; Amanda M Y Tang; Benny Zee; W Y Lau; Paul B S Lai; K L Leung; Joseph T F Lau; Simon C H Yu; Philip J Johnson Journal: Cancer Date: 2002-03-15 Impact factor: 6.860
Authors: Vincenzo Mazzaferro; Josep M Llovet; Rosalba Miceli; Sherrie Bhoori; Marcello Schiavo; Luigi Mariani; Tiziana Camerini; Sasan Roayaie; Myron E Schwartz; Gian Luca Grazi; René Adam; Peter Neuhaus; Mauro Salizzoni; Jordi Bruix; Alejandro Forner; Luciano De Carlis; Umberto Cillo; Andrew K Burroughs; Roberto Troisi; Massimo Rossi; Giorgio E Gerunda; Jan Lerut; Jacques Belghiti; Ilka Boin; Jean Gugenheim; Fedja Rochling; Bart Van Hoek; Pietro Majno Journal: Lancet Oncol Date: 2008-12-04 Impact factor: 41.316
Authors: Luigi Bolondi; Andrew Burroughs; Jean-François Dufour; Peter R Galle; Vincenzo Mazzaferro; Fabio Piscaglia; Jean Luc Raoul; Bruno Sangro Journal: Semin Liver Dis Date: 2013-02-08 Impact factor: 6.115