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Prognosis of Hepatocellular Carcinoma in Relation to Treatment Across BCLC Stages

  • Hepatobiliary Tumors
  • Published:
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Abstract

Background

The Barcelona Clinic Liver Cancer (BCLC) staging system recommends first-line therapy for each tumor stage. We evaluated the effect of compliance with BCLC treatment allocation on the prognosis of patients with hepatocellular carcinoma (HCC).

Methods

We retrospectively analyzed 359 consecutive, newly diagnosed HCC patients treated in our Liver Unit during a 14-year period. For each stage, survival was compared according to whether treatment matched the BCLC recommendation. We also compared the survival of patients in the same BCLC stage who received different treatments, and patients in different BCLC stages receiving the same treatment.

Results

BCLC-A patients treated with radical therapies (66%) survived longer (117 vs. 20 months; p < 0.001) than patients (33%) who received locoregional or systemic therapies. Survival of BCLC-B patients treated with locoregional treatments (57%) was shorter (24 vs. 71 months; p < 0.001) than that of patients receiving radical therapies (32%). BCLC-C patients treated with systemic therapy or supportive care survived shorter (6 vs. 11 months; p = 0.003) than those receiving locoregional therapies (39%). Survival of BCLC-D patients receiving systemic therapies or supportive care was significantly lower than that of patients treated by liver transplantation (5 vs. 137 months; p < 0.001).

Conclusions

In addition to BCLC stage, actual treatment determines survival in patients with HCC.

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Acknowledgment

CIBEREHD is funded by Insituto de Salud Carlos III. This work also was funded in part by Acción Transversal contra el Cáncer.

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Authors and Affiliations

  1. Liver Unit, Clinica Universitaria de Navarra, Pamplona, Spain

    Delia D’Avola MD, Mercedes Iñarrairaegui MD, PhD, Felix Alegre MD, Erica Mauleón MD, José I. Herrero MD, PhD, Jorge Quiroga MD, PhD, Jesus Prieto MD, PhD & Bruno Sangro MD, PhD

  2. Centro de Investigación Biomédica en Red en el Área temática de Enfermedades Hepáticas y Digestivas (CIBERehd), Pamplona, Spain

    Delia D’Avola MD, Mercedes Iñarrairaegui MD, PhD, José I. Herrero MD, PhD, Jorge Quiroga MD, PhD, Jesus Prieto MD, PhD & Bruno Sangro MD, PhD

  3. Department of Hepatobiliary Surgery, Clinica Universitaria de Navarra, Pamplona, Spain

    Fernando Pardo MD, Fernando Rotellar MD, PhD & Pablo Marti MD

  4. Department of Radiology, Clinica Universitaria de Navarra, Pamplona, Spain

    José I. Bilbao MD, PhD, Antonio Martinez-Cuesta MD & Alberto Benito MD, PhD

Authors
  1. Delia D’Avola MD
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  2. Mercedes Iñarrairaegui MD, PhD
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  3. Fernando Pardo MD
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  4. Fernando Rotellar MD, PhD
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  5. Pablo Marti MD
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  6. José I. Bilbao MD, PhD
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  7. Antonio Martinez-Cuesta MD
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  8. Alberto Benito MD, PhD
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  9. Felix Alegre MD
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  10. Erica Mauleón MD
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  11. José I. Herrero MD, PhD
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  12. Jorge Quiroga MD, PhD
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  13. Jesus Prieto MD, PhD
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  14. Bruno Sangro MD, PhD
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Corresponding author

Correspondence to Bruno Sangro MD, PhD.

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D’Avola, D., Iñarrairaegui, M., Pardo, F. et al. Prognosis of Hepatocellular Carcinoma in Relation to Treatment Across BCLC Stages. Ann Surg Oncol 18, 1964–1971 (2011). https://doi.org/10.1245/s10434-011-1551-4

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  • DOI: https://doi.org/10.1245/s10434-011-1551-4

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