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
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 under...
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| Veröffentlicht in: | Journal of surgical oncology 2020-12, Vol.122 (8), p.1587-1594 |
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| creator | Liu, Yueh‐Wei Yong, Chee‐Chien Lin, Chih‐Che Wang, Chih‐Chi Chen, Chao‐Long Cheng, Yu‐Fan Wang, Jing‐Houng Yen, Yi‐Hao Chen, Chien‐Hung |
| description | 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 |
| doi_str_mv | 10.1002/jso.26183 |
| format | Article |
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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.</description><identifier>ISSN: 0022-4790</identifier><identifier>EISSN: 1096-9098</identifier><identifier>DOI: 10.1002/jso.26183</identifier><identifier>PMID: 32815189</identifier><language>eng</language><publisher>United States: Wiley Subscription Services, Inc</publisher><subject>Aged ; Barcelona Clinic Liver Cancer ; Carcinoma, Hepatocellular - epidemiology ; Carcinoma, Hepatocellular - pathology ; Carcinoma, Hepatocellular - surgery ; Far East - epidemiology ; Female ; Follow-Up Studies ; Hepatectomy ; Hepatectomy - methods ; hepatocellular carcinoma ; Hospitals, High-Volume - statistics & numerical data ; Humans ; Liver cancer ; Liver Neoplasms - epidemiology ; Liver Neoplasms - pathology ; Liver Neoplasms - surgery ; liver resection ; Male ; Middle Aged ; Neoplasm Recurrence, Local - epidemiology ; Neoplasm Recurrence, Local - pathology ; Neoplasm Recurrence, Local - surgery ; Patient Selection ; Practice Guidelines as Topic - standards ; Prognosis ; Retrospective Studies</subject><ispartof>Journal of surgical oncology, 2020-12, Vol.122 (8), p.1587-1594</ispartof><rights>2020 Wiley Periodicals LLC</rights><rights>2020 Wiley Periodicals LLC.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3533-51f15ac0746a6d17de60ffc41a558ce491a381fb2a6c802d56abe8a5492ddcee3</citedby><cites>FETCH-LOGICAL-c3533-51f15ac0746a6d17de60ffc41a558ce491a381fb2a6c802d56abe8a5492ddcee3</cites><orcidid>0000-0001-6251-7230</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fjso.26183$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fjso.26183$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,777,781,1412,27905,27906,45555,45556</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32815189$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Liu, Yueh‐Wei</creatorcontrib><creatorcontrib>Yong, Chee‐Chien</creatorcontrib><creatorcontrib>Lin, Chih‐Che</creatorcontrib><creatorcontrib>Wang, Chih‐Chi</creatorcontrib><creatorcontrib>Chen, Chao‐Long</creatorcontrib><creatorcontrib>Cheng, Yu‐Fan</creatorcontrib><creatorcontrib>Wang, Jing‐Houng</creatorcontrib><creatorcontrib>Yen, Yi‐Hao</creatorcontrib><creatorcontrib>Chen, Chien‐Hung</creatorcontrib><title>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</title><title>Journal of surgical oncology</title><addtitle>J Surg Oncol</addtitle><description>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.</description><subject>Aged</subject><subject>Barcelona Clinic Liver Cancer</subject><subject>Carcinoma, Hepatocellular - epidemiology</subject><subject>Carcinoma, Hepatocellular - pathology</subject><subject>Carcinoma, Hepatocellular - surgery</subject><subject>Far East - epidemiology</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Hepatectomy</subject><subject>Hepatectomy - methods</subject><subject>hepatocellular carcinoma</subject><subject>Hospitals, High-Volume - statistics & numerical data</subject><subject>Humans</subject><subject>Liver cancer</subject><subject>Liver Neoplasms - epidemiology</subject><subject>Liver Neoplasms - pathology</subject><subject>Liver Neoplasms - surgery</subject><subject>liver resection</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Neoplasm Recurrence, Local - epidemiology</subject><subject>Neoplasm Recurrence, Local - pathology</subject><subject>Neoplasm Recurrence, Local - surgery</subject><subject>Patient Selection</subject><subject>Practice Guidelines as Topic - standards</subject><subject>Prognosis</subject><subject>Retrospective Studies</subject><issn>0022-4790</issn><issn>1096-9098</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kc1u1DAUhS0EokNhwQsgS2xgkdZ2Yidh145KAY1UiZ91dMe5mXjk2IOdtJodj8Dr8Do8ST1N6aISqyP7fjrn6h5CXnN2whkTp9voT4TiVf6ELDirVVazunpKFmkmsqKs2RF5EeOWMVbXqnhOjnJRccmrekH-rMw1Bhowoh6Nd9R3tMcdjF6jtZOFQDUEbZwfgN6YsTeOgmvpGvc-ydgjPU9ztN4BXVrjjKaz5RKcTrKZTIvpH1OG9sOAroVDUPxAv2Kc7BhpF_xAgfZm0__99fva22lAau9M4hQ2GPZUoxvTM4VfQBzpWTTwkjzrwEZ8da_H5MfHi-_LT9nq6vLz8myV6VzmeSZ5xyVoVhYKVMvLFhXrOl1wkLLSWNQc8op3awFKV0y0UsEaK5BFLdpWI-bH5N3suwv-54RxbAYTD8cBh36KjShyWUolhUzo20fo1k_Bpe0SVXKZ9mEqUe9nSgcfY8Cu2QUzQNg3nDWHPpvUZ3PXZ2Lf3DtO6wHbB_JfgQk4nYEbY3H_f6fmy7er2fIWbgGuxw</recordid><startdate>20201201</startdate><enddate>20201201</enddate><creator>Liu, Yueh‐Wei</creator><creator>Yong, Chee‐Chien</creator><creator>Lin, Chih‐Che</creator><creator>Wang, Chih‐Chi</creator><creator>Chen, Chao‐Long</creator><creator>Cheng, Yu‐Fan</creator><creator>Wang, Jing‐Houng</creator><creator>Yen, Yi‐Hao</creator><creator>Chen, Chien‐Hung</creator><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-6251-7230</orcidid></search><sort><creationdate>20201201</creationdate><title>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</title><author>Liu, Yueh‐Wei ; Yong, Chee‐Chien ; Lin, Chih‐Che ; Wang, Chih‐Chi ; Chen, Chao‐Long ; Cheng, Yu‐Fan ; Wang, Jing‐Houng ; Yen, Yi‐Hao ; Chen, Chien‐Hung</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3533-51f15ac0746a6d17de60ffc41a558ce491a381fb2a6c802d56abe8a5492ddcee3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Aged</topic><topic>Barcelona Clinic Liver Cancer</topic><topic>Carcinoma, Hepatocellular - epidemiology</topic><topic>Carcinoma, Hepatocellular - pathology</topic><topic>Carcinoma, Hepatocellular - surgery</topic><topic>Far East - epidemiology</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Hepatectomy</topic><topic>Hepatectomy - methods</topic><topic>hepatocellular carcinoma</topic><topic>Hospitals, High-Volume - statistics & numerical data</topic><topic>Humans</topic><topic>Liver cancer</topic><topic>Liver Neoplasms - epidemiology</topic><topic>Liver Neoplasms - pathology</topic><topic>Liver Neoplasms - surgery</topic><topic>liver resection</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Neoplasm Recurrence, Local - epidemiology</topic><topic>Neoplasm Recurrence, Local - pathology</topic><topic>Neoplasm Recurrence, Local - surgery</topic><topic>Patient Selection</topic><topic>Practice Guidelines as Topic - standards</topic><topic>Prognosis</topic><topic>Retrospective Studies</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Liu, Yueh‐Wei</creatorcontrib><creatorcontrib>Yong, Chee‐Chien</creatorcontrib><creatorcontrib>Lin, Chih‐Che</creatorcontrib><creatorcontrib>Wang, Chih‐Chi</creatorcontrib><creatorcontrib>Chen, Chao‐Long</creatorcontrib><creatorcontrib>Cheng, Yu‐Fan</creatorcontrib><creatorcontrib>Wang, Jing‐Houng</creatorcontrib><creatorcontrib>Yen, Yi‐Hao</creatorcontrib><creatorcontrib>Chen, Chien‐Hung</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of surgical oncology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Liu, Yueh‐Wei</au><au>Yong, Chee‐Chien</au><au>Lin, Chih‐Che</au><au>Wang, Chih‐Chi</au><au>Chen, Chao‐Long</au><au>Cheng, Yu‐Fan</au><au>Wang, Jing‐Houng</au><au>Yen, Yi‐Hao</au><au>Chen, Chien‐Hung</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>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</atitle><jtitle>Journal of surgical oncology</jtitle><addtitle>J Surg Oncol</addtitle><date>2020-12-01</date><risdate>2020</risdate><volume>122</volume><issue>8</issue><spage>1587</spage><epage>1594</epage><pages>1587-1594</pages><issn>0022-4790</issn><eissn>1096-9098</eissn><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.</abstract><cop>United States</cop><pub>Wiley Subscription Services, Inc</pub><pmid>32815189</pmid><doi>10.1002/jso.26183</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0001-6251-7230</orcidid></addata></record> |
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| subjects | Aged Barcelona Clinic Liver Cancer Carcinoma, Hepatocellular - epidemiology Carcinoma, Hepatocellular - pathology Carcinoma, Hepatocellular - surgery Far East - epidemiology Female Follow-Up Studies Hepatectomy Hepatectomy - methods hepatocellular carcinoma Hospitals, High-Volume - statistics & numerical data Humans Liver cancer Liver Neoplasms - epidemiology Liver Neoplasms - pathology Liver Neoplasms - surgery liver resection Male Middle Aged Neoplasm Recurrence, Local - epidemiology Neoplasm Recurrence, Local - pathology Neoplasm Recurrence, Local - surgery Patient Selection Practice Guidelines as Topic - standards Prognosis Retrospective Studies |
| title | 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 |
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