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Prognosis of patients with intermediate-stage hepatocellular carcinomas based on the Child-Pugh score: subclassifying the intermediate stage (Barcelona Clinic Liver Cancer stage B)

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Japanese Journal of Radiology Aims and scope Submit manuscript

Abstract

Purpose

Retrospective evaluation of intermediate-stage hepatocellular carcinoma (HCC) patient survival after undergoing chemoembolization based on the Child-Pugh score.

Materials and methods

Data of intermediate-stage HCC patients undergoing chemoembolization were gathered from 43 centers in Japan. Overall survival rates were compared with Child-Pugh scores.

Results

Of the 329 patients examined in this study, Child-Pugh scores were 5 (CP-5) in 136 patients (41.3 %), 6 (CP-6) in 101 patients (30.7 %), 7 (CP-7) in 58 (17.7 %), 8 (CP-8) in 22 (6.7 %), and 9 (CP-9) in 12 (3.6 %). Two-year survival rates were 77.5 % in CP-5 patients (p = 0.047 vs. CP-6), 65.1 % in CP-6 patients (p = 0.038 vs. CP-7), 51.3 % in CP-7 patients (p = 0.30 vs. CP-8, p = 0.034 vs. CP-9), 50.3 % in CP-8 patients (p = 0.0065 vs. CP-9), and 16.7 % in CP-9 patients. Two-year survival rates were 77.2 % in 139 patients meeting the 4 tumors of 7 cm criterion with Child-Pugh class A (B1) (p < 0.0001 vs. B2), 59.5 % in 178 patients other than B1 and B3 (B2) (p = 0.0014 vs. B3), and 16.7 % in 12 patients with Child-Pugh score 9 (B3).

Conclusion

The Child-Pugh score is a useful prognostic factor to stratify intermediate-stage HCC patients.

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References

  1. Llovet JM, Burroughs A, Bruix J. Hepatocellular carcinoma. Lancet. 2003;362:1907–17.

    Article  PubMed  Google Scholar 

  2. de Lope CR, Tremosini S, Forner A, Reig M, Bruix J. Management of HCC. J Hepatol. 2012;56(Suppl 1):S75–87.

    Article  PubMed  Google Scholar 

  3. Bolondi L, Burroughs A, Dufour JF, Galle PR, Mazzaferro V, Piscaglia F, et al. Heterogeneity of patients with intermediate (BCLC B) hepatocellular carcinoma: proposal for a subclassification to facilitate treatment decisions. Semin Liver Dis. 2012;32(4):348–59.

    CAS  PubMed  Google Scholar 

  4. Camma C, Schepis F, Orlando A, Albanese M, Shahied L, Trevisani F, et al. Transarterial chemoembolization for unresectable hepatocellular carcinoma: meta-analysis of randomized controlled trials. Radiology. 2002;224:47–54.

    Article  PubMed  Google Scholar 

  5. Llovet JM, Bruix J. Systematic review of randomized trials for unresectable hepatocellular carcinoma: chemoembolization improves survival. Hepatology. 2003;37:429–42.

    Article  CAS  PubMed  Google Scholar 

  6. Llovet JM, Real MI, Montan X, Planas R, Coll S, Aponte J, et al. Arterial embolisation or chemoembolisation versus symptomatic treatment in patients with unresectable hepatocellular carcinoma: a randomized controlled trial. Lancet. 2002;359:1734–9.

    Article  PubMed  Google Scholar 

  7. Yamakado K, Miyayama S, Hirota S, Mizunuma K, Nakamura K, Inaba Y, et al. Subgrouping of intermediate-stage (BCLC stage B) hepatocellular carcinoma based on tumor number and size and Child-Pugh grade correlated with prognosis after transarterial chemoembolization. Jpn J Radiol. 2014;32:260–5.

    Article  CAS  PubMed  Google Scholar 

  8. Mazzaferro V, Llovet JM, Miceli R, Bhoori S, Schiavo M, Mariani L, et al. Metroticket Investigator Study Group. Predicting survival after liver transplantation in patients with hepatocellular carcinoma beyond the Milan criteria: a retrospective, exploratory analysis. Lancet Oncol. 2009;10:35–43.

    Article  PubMed  Google Scholar 

  9. Piscaglia F, Terzi E, Cucchetti A, Trimarchi C, Granito A, Leoni S, et al. Treatment of hepatocellular carcinoma in Child-Pugh B patients. Dig Liver Dis. 2013;45:852–8.

    Article  PubMed  Google Scholar 

  10. Yamakado K, Miyayama S, Hirota S, Mizunuma K, Nakamura K, Inaba Y, et al. Hepatic arterial embolization for unresectable hepatocellular carcinomas: do technical factors affect prognosis? Jpn J Radiol. 2012;30:560–6.

    Article  PubMed  Google Scholar 

  11. Bruix J, Sherman M. Practice Guidelines Committee, American Association for the Study of Liver Diseases. Management of hepatocellular carcinoma. Hepatology. 2005;42:1208–36.

    Article  PubMed  Google Scholar 

  12. Ha Y, Shim JH, Kim SO, Kim KM, Lim YS, Lee HC. Clinical appraisal of the recently proposed Barcelona clinic liver cancer stage B subclassification by survival analysis. J Gastroenterol Hepatol. 2014;29:787–93.

    Article  PubMed  Google Scholar 

  13. Cabibbo G, Maida M, Genco C, Parisi P, Peralta M, Antonucci M, et al. Natural history of untreatable hepatocellular carcinoma: a retrospective cohort study. World J Hepatol. 2012;27(4):256–61.

    Article  Google Scholar 

Download references

Acknowledgments

We thank the following institutions and doctors for supporting this study: (1) Okitama Public General Hospital, Department of Radiology, Hitoshi Ito, MD; (2) Toho University Omori Hospital, Department of Department of Gastroenterology and Hepatology, Manabu Watanabe, MD; (3) National Center for Global Health and Medicine, Department of Radiology, KanehiroHasuo, MD; (4) Tokai University, Department of Radiology, Takeshi Hashimoto, MD; (5) Yamanashi University, Department of Radiology, Hiroki Okada, MD; (6) Shinshu University, Department of Radiology, Kazuhiko Ueda, MD; (7) Kouseiren Takaoka Hospital, Department of Radiology, Koji Nobata, MD; (8) Ishikawa Prefectural Central Hospital, Department of Radiology, Takeshi Kobayashi, MD; (9) Hamamatsu University School of Medicine, Department of Radiology, Mika Kamiya, MD; (10) Nagoya City University, Department of Radiology, Masashi Shimohira, MD; (11) Aichi Medical University, Department of Radiology, Seiji Kamei, MD; (12) Shiga University of Medical Science, Department of Radiology, Norihisa Nitta, MD; (13) Kohka Public Hospital, Department of Radiology, Michio Yamasaki, MD; (14) Japanese Red Cross Kobe Hospital, Department of Radiology, Koji Sugimoto, MD; (15) Nishi-Kobe Medical Center, Department of Radiology, YoichiroKuwata,MD; (16) Wakayama Medical University, Department of Radiology, Nobuyuki Kawai, MD; (17) Hiroshima University, Department of Radiology, Hideaki Kakizawa, MD; (18) Chugoku Rosai Hospital, Department of Radiology, Akira Naito, MD; (19) Tottori University, Department of Radiology, Toshio Kamino, MD; (20) Shimane University, Department of Radiology, Masakatsu Tsurusaki, MD; (21) Oita University, Department of Radiology, Hiromu Mori, MD; (22) Kumamoto University, Department of Radiology, Osamu Ikeda, MD; (23) Kagoshima University, Department of Radiology, Yasutaka Baba, MD; (24) Kanazawa University, Department of Radiology, Tetsuya Minami, MD; (25) Hokkaido University, Department of Radiology, Daisuke Abo, MD; (26) Okayama University, Department of Radiology, Hideo Gobara, MD; (27) Osaka University, Department of Radiology, Keigo Osuga, MD; (28) National Cancer Center, Department of Diagnostic Radiology, Yoshito Takeuchi; (29) Teikyo University, Department of Radiology, Hiroshi Kotake, MD; (30) Kyoto Second Red Cross Hospital, Department of Radiology, Hiroyuki Morishita, MD; (31) Kochi Health Science Center, Department of Radiology, Yasuhiro Hata, MD; (32) Nanbu Medical Center, Department of Radiology, Fumikiyo Ganaha, MD; (33) Keio University, Department of Diagnostic Radiology, Sachio Kuribayashi, MD.

Conflict of interest

There are no conflicts of interest to disclose from any of the authors.

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Authors and Affiliations

  1. Department of Interventional Radiology, School of Medicine, Mie University, 2-174 Edobashi, Tsu, Mie, 514-8507, Japan

    Koichiro Yamakado

  2. Department of Diagnostic Radiology, Fukui-ken Saiseikai Hospital, Fukui, Japan

    Shiro Miyayama

  3. Department of Radiology, Hyogo College of Medicine, Nishinomiya, Japan

    Shozo Hirota & Satoshi Yamamoto

  4. Department of Radiology, Nasu Red Cross Hospital, Nasu, Japan

    Kimiyoshi Mizunuma

  5. Department of Radiology, Daito Central Hospital, Daito, Japan

    Kenji Nakamura

  6. Department of Diagnostic and Interventional Radiology, Aichi Cancer Center Hospital and Research Institute, Nagoya, Aichi, Japan

    Yoshitaka Inaba

  7. Department of Radiology, Narumi Hospital, Aomori, Japan

    Kunihiro Matsuo

  8. Department of Radiology, Osaka City University, Osaka, Japan

    Norifumi Nishida

  9. Department of Diagnostic Radiology, Shizuoka Cancer Center, Shizuoka, Japan

    Takeshi Aramaki

  10. Department of Radiology, Nara Medical University, Kashihara, Japan

    Hiroshi Anai

  11. Department of Radiology, Fukuoka University, Fukuoka, Japan

    Shinichi Kora

  12. Department of Radiology, Iwate Prefectural Central Hospital, Morioka, Japan

    Shigeo Oikawa

  13. Department of Radiology, Jikei University, Tokyo, Japan

    Ken Watanabe

  14. Department of Radiology, Toyonaka Municipal Hospital, Toyonaka, Japan

    Taku Yasumoto

  15. Department of Radiology, Higashiosaka City General Hospital, Higashiosaka, Japan

    Kinya Furuichi

  16. Department of Radiology, Kobe University, Kobe, Japan

    Masato Yamaguchi

Authors
  1. Koichiro Yamakado
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  2. Shiro Miyayama
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  3. Shozo Hirota
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  4. Kimiyoshi Mizunuma
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  5. Kenji Nakamura
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  6. Yoshitaka Inaba
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  7. Satoshi Yamamoto
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  8. Kunihiro Matsuo
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  9. Norifumi Nishida
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  10. Takeshi Aramaki
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  11. Hiroshi Anai
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  12. Shinichi Kora
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  13. Shigeo Oikawa
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  14. Ken Watanabe
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  15. Taku Yasumoto
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  16. Kinya Furuichi
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  17. Masato Yamaguchi
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Corresponding author

Correspondence to Koichiro Yamakado.

Additional information

On behalf of the Clinical Research Group of the Japanese Society for Transcatheter Hepatic Arterial Embolization.

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Yamakado, K., Miyayama, S., Hirota, S. et al. Prognosis of patients with intermediate-stage hepatocellular carcinomas based on the Child-Pugh score: subclassifying the intermediate stage (Barcelona Clinic Liver Cancer stage B). Jpn J Radiol 32, 644–649 (2014). https://doi.org/10.1007/s11604-014-0358-1

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  • DOI: https://doi.org/10.1007/s11604-014-0358-1

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