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Prognosis After Resection of Barcelona Clinic Liver Cancer (BCLC) Stage 0, A, and B Hepatocellular Carcinoma: A Comprehensive Assessment of the Current BCLC Classification

2019-10Journal article Open access
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dc.contributor.authorTsilimigras, D
dc.contributor.authorBagante, F
dc.contributor.authorSahara, K
dc.contributor.authorMoris, D
dc.contributor.authorHyer, J
dc.contributor.authorWu, L
dc.contributor.authorRatti, F
dc.contributor.authorPinto Marques, H
dc.contributor.authorSoubrane, O
dc.contributor.authorParedes, A
dc.contributor.authorLam, V
dc.contributor.authorPoultsides, G
dc.contributor.authorPopescu, I
dc.contributor.authorAlexandrescu, S
dc.contributor.authorMartel, G
dc.contributor.authorWorkneh, A
dc.contributor.authorGuglielmi, A
dc.contributor.authorHugh, T
dc.contributor.authorAldrighetti, L
dc.contributor.authorEndo, I
dc.contributor.authorPawlik, T
dc.date.accessioned2021-04-30T15:06:42Z
dc.date.available2021-04-30T15:06:42Z
dc.date.issued2019-10
dc.description.abstractBackground: Although the Barcelona Clinic Liver Cancer (BCLC) staging system has been largely adopted in clinical practice, recent studies have questioned the prognostic stratification of this classification schema, as well as the proposed treatment allocation of patients with a single large tumor. Methods: Patients who underwent curative-intent hepatectomy for histologically proven hepatocellular carcinoma (HCC) between 1998 and 2017 were identified using an international multi-institutional database. Overall survival (OS) among patients with BCLC stage 0, A, and B was examined. Patients with a single large tumor were classified as BCLC stage A1 and were independently assessed. Results: Among 814 patients, 68 (8.4%) were BCLC-0, 310 (38.1%) were BCLC-A, 279 (34.3%) were BCLC-A1, and 157 (19.3%) were BCLC-B. Five-year OS among patients with BCLC stage 0, A, A1, and B HCC was 86.2%, 69.0%, 56.9%, and 49.9%, respectively (p < 0.001). Among patients with very early- and early-stage HCC (BCLC 0, A, and A1), patients with BCLC stage A1 had the worst OS (p = 0.0016). No difference in survival was noted among patients undergoing surgery for BCLC stage A1 and B HCC (5-year OS: 56.9% vs. 49.9%; p = 0.259) even after adjusting for competing factors (hazard ratio 0.83, 95% confidence interval 0.54-1.28; p = 0.40). Conclusion: Prognosis following liver resection among patients with BCLC-A1 HCC was similar to patients presenting with BCLC-B tumors. Surgery provided acceptable long-term outcomes among select patients with BCLC-B HCC. Designation into BCLC stage B should not be considered an a priori contraindication to surgery.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationAnn Surg Oncol. 2019 Oct;26(11):3693-3700.pt_PT
dc.identifier.doi10.1245/s10434-019-07580-9pt_PT
dc.identifier.urihttp://hdl.handle.net/10400.17/3682
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherSpringerpt_PT
dc.subjectAgedpt_PT
dc.subjectCarcinoma, Hepatocellularpt_PT
dc.subjectFemalept_PT
dc.subjectFollow-Up Studiespt_PT
dc.subjectHepatectomypt_PT
dc.subjectHumanspt_PT
dc.subjectLiver Neoplasmspt_PT
dc.subjectMalept_PT
dc.subjectMiddle Agedpt_PT
dc.subjectNeoplasm Stagingpt_PT
dc.subjectPredictive Value of Testspt_PT
dc.subjectRetrospective Studiespt_PT
dc.subjectSurvival Ratept_PT
dc.subjectHCC CIRpt_PT
dc.titlePrognosis After Resection of Barcelona Clinic Liver Cancer (BCLC) Stage 0, A, and B Hepatocellular Carcinoma: A Comprehensive Assessment of the Current BCLC Classificationpt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage3700pt_PT
oaire.citation.issue11pt_PT
oaire.citation.startPage3693pt_PT
oaire.citation.titleAnnals of Surgical Oncologypt_PT
oaire.citation.volume26pt_PT
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT

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