The Improvement in 1-Year Survival Rate of Patients with Hepatocellular Carcinoma BCLC Stage A and B after the Implementation of Comprehensive Management

  • Juferdy KurniawanEmail author
  • Rino A. Gani
  • Irsan Hasan
  • Andri S. Sulaiman
  • Cosmas R. A. Lesmana
  • Chyntia O. M. Jasirwan
  • Kemal F. Kalista
  • Saut H. H. Nababan
  • Steven Zulkifly
Original Research



The previous study showed lack of improvement in survival rate of hepatocellular carcinoma (HCC) patients in 2013–2014 period compared to 1998–1999 period in Indonesia due to late diagnosis. Comprehensive management of HCC has been implemented since 2015 in Cipto Mangunkusumo National General Hospital. This aims to provide better screening and surveillance in HCC patients and prioritizing of more proactive approach, such as online patient’s group discussion and social media education.


To compare the survival rates in HCC BCLC stage A and B before and after the implementation of comprehensive management.


A retrospective study design was conducted in this study. We compared the database of HCC BCLC A and B patients between the 2015–2017 period and the 2013–2014 period. Clinical parameters, modality of treatment, and 1-year survival rate were analyzed.


A total of 50 patients from 2013 to 2014 period and 143 patients from 2015 to 2017 period were included in this study. After the implementation of comprehensive management, the number of patients detected in BCLC class A increased significantly (p = 0.003). In 2015–2017 period, the number of patients that received curative treatment increased significantly (p = 0.018). The 1-year survival rate of the 2015–2017 group and the 2013–2014 group was 73.9% and 47.9%, respectively, with p value 0.002.


The 1-year survival rate of BCLC A and BCLC B HCC patients in Cipto Mangunkusumo National Hospital improved significantly after the implementation of comprehensive management of HCC in 2015.


Comprehensive management Curative Hepatectomy Hepatocellular carcinoma Radiofrequency ablation Surveillance Survival rate 



We would like to thank Ms. Gita Aprilicia for her support in this study.

Compliance with Ethical Standards

The study protocol has been approved by the Ethics Committee of the Faculty of Medicine Universitas Indonesia on human research with number protocol 18-01-0018.

Conflict of Interest

The authors declare that they have no conflict of interest.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Juferdy Kurniawan
    • 1
    Email author
  • Rino A. Gani
    • 1
  • Irsan Hasan
    • 1
  • Andri S. Sulaiman
    • 1
  • Cosmas R. A. Lesmana
    • 1
  • Chyntia O. M. Jasirwan
    • 1
  • Kemal F. Kalista
    • 1
  • Saut H. H. Nababan
    • 1
  • Steven Zulkifly
    • 1
  1. 1.Hepatobiliary Division, Department of Internal Medicine, Faculty of MedicineUniversitas Indonesia, Cipto Mangunkusumo National General HospitalCentral JakartaIndonesia

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