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

World Journal of Surgery volume 36, pages 1811–1823 (2012)Cite this article

Abstract

Background

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.

Methods

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.

Results

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.

Conclusions

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

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Affiliations

  1. Fifth Department of Hepatic Surgery, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, No. 225 Changhai Road, Shanghai, 200438, People’s Republic of China

    Wen-Chao Zhao, Ning Yang, Nan Zhu, Hai-Bin Zhang, Yong Fu, Ben-Dong Chen & Guang-Shun Yang

  2. Department of Liver Disease, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, No. 225 Changhai Road, Shanghai, 200438, People’s Republic of China

    Hua-Bang Zhou

  3. Department of Surgery, 43rd Hospital of the Chinese People’s Liberation Army, No. 212 Daguan Road, Kunming, 650000, Yunnan Province, People’s Republic of China

    Wen-Ke Cai

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  1. Wen-Chao Zhao
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  2. Ning Yang
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  3. Nan Zhu
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  4. Hai-Bin Zhang
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  5. Yong Fu
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  6. Hua-Bang Zhou
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  7. Wen-Ke Cai
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  8. Ben-Dong Chen
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  9. Guang-Shun Yang
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Corresponding author

Correspondence to Guang-Shun Yang.

Additional information

Wen-Chao Zhao and Ning Yang contributed equally to this work.

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Zhao, WC., Yang, N., Zhu, N. et al. Patients with Multiple Hepatocellular Carcinomas Within the UCSF Criteria Have Outcomes After Curative Resection Similar to Patients Within the BCLC Early-Stage Criteria. World J Surg 36, 1811–1823 (2012). https://doi.org/10.1007/s00268-012-1601-5

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Keywords

  • Overall Survival
  • Tace
  • Hepatic Resection
  • Barcelona Clinic Liver Cancer
  • Microvascular Invasion