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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
Author(s) -
Liu YuehWei,
Yong CheeChien,
Lin ChihChe,
Wang ChihChi,
Chen ChaoLong,
Cheng YuFan,
Wang JingHoung,
Yen YiHao,
Chen ChienHung
Publication year - 2020
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.26183
Subject(s) - medicine , hepatocellular carcinoma , liver cancer , guideline , hazard ratio , stage (stratigraphy) , cancer , gastroenterology , retrospective cohort study , confidence interval , pathology , biology , paleontology
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.