Selection criteria for hepatic resection in intermediate-stage (BCLC stage B) multiple hepatocellular carcinoma

Hiroshi Wada, Hidetoshi Eguchi, Takehiro Noda, Hisataka Ogawa, Daisaku Yamada, Yoshito Tomimaru, Akira Tomokuni, Tadafumi Asaoka, Koichi Kawamoto, Kunihito Gotoh, Shigeru Marubashi, Koji Umeshita, Hiroaki Nagano, Yuichiro Doki, Masaki Mori

研究成果: Contribution to journalArticle査読

27 被引用数 (Scopus)

抄録

Background Several reports have suggested that hepatic resection provides a survival benefit in patients with hepatocellular carcinoma (HCC) at the intermediate stage of the Barcelona Clinic Liver Cancer classification (BCLC-B). The operative indications for multiple BCLC-B have not been established, however. The aim of this study was to clarify the survival benefit of hepatic resection for multinodular BCLC-B HCC. Methods We retrospectively analyzed 85 patients with BCLC-B HCC who underwent liver resection. To evaluate clinicopathologic factors and survival, we divided the patients into 3 types based on radiologic findings regarding tumor number and maximum tumor diameter: type 1, up to 3 lesions <5 cm; type 2, up to 3 lesions ≥5 cm or 4 nodules of any size; type 3, >4 nodules. Results Thirty-four patients were classified as type 1, 32 as type 2, and 19 as type 3. The 1-, 3-, and 5-year survival in type 1 were 97.1%, 87.4%, and 75.2%, respectively. Those in type 2 were 84.0%, 74.0%, and 63.0%, and those in type 3 were 64.9%, 55.7%, and 37.1%, respectively. The overall survival of type 1 patients was significantly better than that of type 3 patients. The prognosis of type 2 patients was worse than that of type 1 patients and better than that of type 3. Multivariate analysis identified radiologic tumor size and tumor number as independent prognostic factors. Conclusion Our findings suggest that hepatic resection should be considered a radical treatment for multinodular BCLC-B HCC. Our subclassification can be applied to select the initial treatment and when making decisions regarding hepatic resection of BCLC-B HCC with multiple nodules.

本文言語英語
ページ(範囲)1227-1235
ページ数9
ジャーナルSurgery (United States)
160
5
DOI
出版ステータス出版済み - 11 1 2016

All Science Journal Classification (ASJC) codes

  • Surgery

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