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Distribution of tumor stage and initial treatment modality in patients with primary hepatocellular carcinoma

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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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Correspondence to B.-D. Xiang or L.-Q. Li.

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Conflict of interest

All authors declare no conflicts of interest.

Ethics approval and consent to participate

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).

Additional information

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

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