Survival Analysis of Single Large (>5 cm) Hepatocellular Carcinoma Patients: BCLC A versus B

Single large (>5 cm) hepatocellular carcinoma (HCC) is classified as Barcelona Liver Clinic (BCLC) stage early stage (A). Yet, controversies exist whether single large HCC can be considered as early stage. We have analyzed long-term outcome to see which stage is appropriate for these patients. Fr...

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Published in:PloS one 2016-11, Vol.11 (11), p.e0165722-e0165722
Main Authors: Cho, Yuri, Sinn, Dong Hyun, Yu, Su Jong, Gwak, Geum Youn, Kim, Ji Hoon, Yoo, Yang Jae, Jun, Dae Won, Kim, Tae Yeob, Lee, Hyo Young, Cho, Eun Ju, Lee, Jeong-Hoon, Kim, Yoon Jun, Yoon, Jung-Hwan
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Carcinoma, Hepatocellular - pathology
Criteria
Hepatitis
Hepatocellular carcinoma
Hospitals
Humans
Internal medicine
Liver
Liver cancer
Liver Cirrhosis - pathology
Liver Neoplasms - pathology
Liver transplants
Medical prognosis
Medicine
Medicine and Health Sciences
Middle Aged
Neoplasm Staging
Nodules
Patient outcomes
Patients
People and Places
Physical Sciences
Physicians
Proportional Hazards Models
Regression analysis
Research and Analysis Methods
Statistical analysis
Surgery
Survival
Survival Analysis
Tumors
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Summary:Single large (>5 cm) hepatocellular carcinoma (HCC) is classified as Barcelona Liver Clinic (BCLC) stage early stage (A). Yet, controversies exist whether single large HCC can be considered as early stage. We have analyzed long-term outcome to see which stage is appropriate for these patients. From 2005 to 2006, 1,546 consecutive patients who were newly diagnosed as HCC (BCLC A or B) at four tertiary hospitals in Korea were analyzed. BCLC A was sub-classified into A1 (single 2-5 cm), A2 (2-3 nodules ≤3 cm), and A3 (single >5 cm). BCLC B1 included patients beyond-Milan criteria, and within up-to-7 criterion. Survival prediction between subgroupings (1: A1 + A2 + A3 vs. B1 and 2: A1 + A2 vs. A3 + B1) was compared based on c-index and Akaike information criterion (AIC). The 5-year overall survival (OS) rate was 62.3, 58.6, 36.8, and 42.0% for A1, A2, A3 and B1, respectively. In multivariate Cox-regression analysis, OS was significantly different between A3 + B1 vs. A1 + A2 (hazard ratio [HR] 1.85; P
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0165722