World Journal of Surgery

, Volume 36, Issue 8, pp 1811–1823 | Cite as

Patients with Multiple Hepatocellular Carcinomas Within the UCSF Criteria Have Outcomes After Curative Resection Similar to Patients Within the BCLC Early-Stage Criteria

  • Wen-Chao Zhao
  • Ning Yang
  • Nan Zhu
  • Hai-Bin Zhang
  • Yong Fu
  • Hua-Bang Zhou
  • Wen-Ke Cai
  • Ben-Dong Chen
  • Guang-Shun YangEmail author



Surgical strategies for the treatment of multiple hepatocellular carcinomas (HCC) remain controversial. This study compared the prognostic power of the University of California, San Francisco (UCSF) criteria with the Barcelona Clinic Liver Cancer (BCLC) early-stage criteria.


Clinical and survival data of 162 multiple-HCC patients in Child-Pugh class A who underwent curative resection were retrospectively reviewed. Prognostic risk factors were analyzed using univariate and multivariate analyses.


UCSF criteria were shown to independently predict overall and disease-free survival. In patients within the UCSF criteria, 3-year overall and disease-free survivals were significantly better than in those exceeding the UCSF criteria (68 vs. 34 % and 54 vs. 26 %, respectively; both p < 0.001). There were no significant differences in 3-year overall and disease-free survival between patients within the UCSF criteria but exceeding the BCLC early stage and patients with BCLC early-stage disease (71 vs. 66 %, p = 0.506 and 57 vs. 50 %, p = 0.666, respectively). Tumors within the UCSF criteria were associated with a lower incidence of high-grade tumor (p = 0.009), microvascular invasion (p = 0.005), 3-month death (p = 0.046), prolonged Pringle’s maneuver (p = 0.005), and surgical margin <0.5 cm (p < 0.001) than those exceeding the UCSF criteria. Tumors within the UCSF criteria but exceeding the BCLC early stage had invasiveness and surgical difficulty similar to those within the BCLC early-stage criteria.


Multiple HCC patients within the UCSF criteria benefit from curative resection. Expansion of curative treatment is justified.


Overall Survival Tace Hepatic Resection Barcelona Clinic Liver Cancer Microvascular Invasion 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Conflict of interest



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Copyright information

© Société Internationale de Chirurgie 2012

Authors and Affiliations

  • Wen-Chao Zhao
    • 1
  • Ning Yang
    • 1
  • Nan Zhu
    • 1
  • Hai-Bin Zhang
    • 1
  • Yong Fu
    • 1
  • Hua-Bang Zhou
    • 2
  • Wen-Ke Cai
    • 3
  • Ben-Dong Chen
    • 1
  • Guang-Shun Yang
    • 1
    Email author
  1. 1.Fifth Department of Hepatic SurgeryEastern Hepatobiliary Surgery Hospital, Second Military Medical UniversityShanghaiPeople’s Republic of China
  2. 2.Department of Liver DiseaseEastern Hepatobiliary Surgery Hospital, Second Military Medical UniversityShanghaiPeople’s Republic of China
  3. 3.Department of Surgery43rd Hospital of the Chinese People’s Liberation ArmyKunmingPeople’s Republic of China

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