Abstract
Objective
This study reviewed the distribution of each tumor stage and each type of initial treatment modality among patients with primary hepatocellular carcinoma (HCC) treated at a tertiary tumor hospital between January 2003 and October 2013.
Methods
Baseline data of patients with primary hepatocellular carcinoma treated between January 2003 and October 2013 were retrospectively collected. Tumor stage was determined according to the Barcelona Clinic Liver Cancer (BCLC) staging system and Hong Kong Clinic Liver Cancer (HKLC) staging system.
Results
A total of 6241 patients with primary hepatocellular carcinoma were included in the analysis. In accordance with the BCLC, 28.9% of patients were in stage 0/A, 16.2% in stage B, 53.6% in stage C, and 1.3% in stage D. According to the HKLC stage system, 8.4% patients were in stage I, 1.5% in stage IIa, 29.0% in stage IIb, 10.0% in stage IIIa, 33.6% in stage IIIb, 3.4% in stage IVa, 2.5% in stage IVb, 0.2% in stage Va, and 11.4% in stage Vb. Treatment modalities applied to this patient group were as follows: 33.3% of patients underwent hepatic resection, 36.7% underwent transarterial chemoembolization (TACE), 2.2% underwent radiotherapy, 0.9% underwent local ablated therapy, 8.8% underwent systemic chemotherapy, 4.2% underwent traditional herbal medicine therapy, 0.1% underwent targeted drug therapy, and 13.8% received no treatment. Hepatic resection was the most frequent therapy for patients with BCLC 0/A/B disease, and TACE was the initial therapy for patients with BCLC C disease. In the Hong Kong Clinic Liver Cancer staging system, the main treatments for HKLC I to IIIb disease is hepatic resection and TACE. Systemic chemotherapy was the initial therapy for patients with HKLC IVa/IVb disease. Most HKLC Va/Vb patients received traditional Chinese medicine treatment.
Conclusion
Prevalence of stage BCLC B and C disease was high among our hepatocellular carcinoma patients. In Hong Kong Clinic Liver Cancer staging system, HKLC I to IIIb disease was high among our HCC patients. Hepatic resection and TACE are initial therapies.
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Abbreviations
- HCC:
-
Hepatocellular carcinoma
- BCLC:
-
Barcelona Clinic Liver Cancer
- HKLC:
-
Hong Kong Clinic Liver Cancer
- HR:
-
Hepatic resection
- NT:
-
No active treatment
- LAT:
-
Local ablated therapy
- RT:
-
Radiotherapy
- SC:
-
Systematic chemotherapy
- So:
-
Sorafenib
- TCM:
-
Tranditional Chinese medicine
- TACE:
-
Transarterial chemoembolization
- CT:
-
Computed tomography
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Acknowledgements
The authors are grateful to department of hepatobiliary surgery, Tumor Hospital Affiliated of Guangxi Medical University for the help with this paper. All authors reviewed the paper and approved the final version.
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All contributing authors are aware of and agree to the submission of this manuscript. No conflict of interest exits in the submission of this manuscript. This study was approved by the institutional review board of Tumor Hospital of Guangxi Medical University. Written consent was given by the patients for their information to be stored in the hospital database and used for research.
Funding
This work was supported by Guangxi Science and Technology Development Projects (14124003-4), the National Science and Technology Major Special Project (2012ZX10002010001009), Guangxi University of Science and Technology Research Projects (KY2015LX056), and the Self-Raised Scientific Research Fund of the Ministry of Health of Guangxi Province (Z2015621, Z2014241).
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X. Xiang and J.-H. Zhong contributed equally to this work.
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Xiang, X., Zhong, JH., Wang, YY. et al. Distribution of tumor stage and initial treatment modality in patients with primary hepatocellular carcinoma. Clin Transl Oncol 19, 891–897 (2017). https://doi.org/10.1007/s12094-017-1621-6
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DOI: https://doi.org/10.1007/s12094-017-1621-6