Prognostic ability of BCLC-B subclassification in patients with hepatocellular carcinoma undergoing transarterial chemoembolization

Marco Biolato, Giulia Gallusi, Massimo Iavarone, Giuseppe Cabibbo, Simona Racco, Adriano De Santis, Cristina Della Corte, Marcello Maida, Adolfo Francesco Attili, Angelo Sangiovanni, Calogero Cammà, Giuseppe La Torre, Antonio Gasbarrini, Antonio Grieco

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4 Citations (Scopus)

Abstract

Background and aims. A subclassification system for intermediate hepatocellular carcinoma (HCC) was recently proposed to optimize treatment allocation. The aim of this study was to assess the prognostic ability of that substaging proposal. Patients and methods. This is a retrospective multicenter cohort study including patients with intermediate HCC treated with transarterial chemoembolization (TACE). Predictors of survival were identified using the Cox proportional regression model. Results. 289 Barcelona Clinic Liver Cancer (BCLC) B patients were included. Median overall survival of the whole cohort was 23 months (C.I. 95% 20.2-25.8). Child A status (H.R. 1.35, C.I. 95% 1.02-1.78) and tumour burden beyond the up-to-seven criterion (H.R. 1.39, C.I. 95% 1.07-1.80) were independent prognostic factors for overall survival on multivariate analysis. Analysis of the substages showed that median survival was 33.0 months for B1 stage (n = 81), 20.8 months for B2 stage (n = 106), 16.1 months for B3 stage (n = 24), 22.2 months for B4 stage (n = 42) and 15.0 months for quasi-C stage (n = 36). Regarding the discriminatory ability of the substaging proposal, the log rank test showed a significant survival difference for B1vs. B4 (p = 0.003) and B1 vs. Quasi-C (p = 0.039) and a trend for B1 vs. B2 (p = 0.05) and B1 vs. B3 (p = 0.05). Conclusions. Apart from substage B1, BCLC-B subclassification does not discriminate perfectly patients treated with TACE. Also some patients in substage B4 can benefit from TACE.

Original languageEnglish
Pages (from-to)110-118
Number of pages9
JournalAnnals of Hepatology
Volume17
Issue number1
DOIs
Publication statusPublished - Jan 1 2018

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Liver Neoplasms
Hepatocellular Carcinoma
Survival
Tumor Burden
Multicenter Studies
Cohort Studies
Multivariate Analysis
Therapeutics

Keywords

  • Chemoembolization
  • Liver cancer
  • Radioembolization
  • Sorafenib
  • Staging system

ASJC Scopus subject areas

  • Hepatology

Cite this

Prognostic ability of BCLC-B subclassification in patients with hepatocellular carcinoma undergoing transarterial chemoembolization. / Biolato, Marco; Gallusi, Giulia; Iavarone, Massimo; Cabibbo, Giuseppe; Racco, Simona; De Santis, Adriano; Corte, Cristina Della; Maida, Marcello; Attili, Adolfo Francesco; Sangiovanni, Angelo; Cammà, Calogero; La Torre, Giuseppe; Gasbarrini, Antonio; Grieco, Antonio.

In: Annals of Hepatology, Vol. 17, No. 1, 01.01.2018, p. 110-118.

Research output: Contribution to journalArticle

Biolato, M, Gallusi, G, Iavarone, M, Cabibbo, G, Racco, S, De Santis, A, Corte, CD, Maida, M, Attili, AF, Sangiovanni, A, Cammà, C, La Torre, G, Gasbarrini, A & Grieco, A 2018, 'Prognostic ability of BCLC-B subclassification in patients with hepatocellular carcinoma undergoing transarterial chemoembolization', Annals of Hepatology, vol. 17, no. 1, pp. 110-118. https://doi.org/10.5604/01.3001.0010.7542
Biolato, Marco ; Gallusi, Giulia ; Iavarone, Massimo ; Cabibbo, Giuseppe ; Racco, Simona ; De Santis, Adriano ; Corte, Cristina Della ; Maida, Marcello ; Attili, Adolfo Francesco ; Sangiovanni, Angelo ; Cammà, Calogero ; La Torre, Giuseppe ; Gasbarrini, Antonio ; Grieco, Antonio. / Prognostic ability of BCLC-B subclassification in patients with hepatocellular carcinoma undergoing transarterial chemoembolization. In: Annals of Hepatology. 2018 ; Vol. 17, No. 1. pp. 110-118.
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abstract = "Background and aims. A subclassification system for intermediate hepatocellular carcinoma (HCC) was recently proposed to optimize treatment allocation. The aim of this study was to assess the prognostic ability of that substaging proposal. Patients and methods. This is a retrospective multicenter cohort study including patients with intermediate HCC treated with transarterial chemoembolization (TACE). Predictors of survival were identified using the Cox proportional regression model. Results. 289 Barcelona Clinic Liver Cancer (BCLC) B patients were included. Median overall survival of the whole cohort was 23 months (C.I. 95{\%} 20.2-25.8). Child A status (H.R. 1.35, C.I. 95{\%} 1.02-1.78) and tumour burden beyond the up-to-seven criterion (H.R. 1.39, C.I. 95{\%} 1.07-1.80) were independent prognostic factors for overall survival on multivariate analysis. Analysis of the substages showed that median survival was 33.0 months for B1 stage (n = 81), 20.8 months for B2 stage (n = 106), 16.1 months for B3 stage (n = 24), 22.2 months for B4 stage (n = 42) and 15.0 months for quasi-C stage (n = 36). Regarding the discriminatory ability of the substaging proposal, the log rank test showed a significant survival difference for B1vs. B4 (p = 0.003) and B1 vs. Quasi-C (p = 0.039) and a trend for B1 vs. B2 (p = 0.05) and B1 vs. B3 (p = 0.05). Conclusions. Apart from substage B1, BCLC-B subclassification does not discriminate perfectly patients treated with TACE. Also some patients in substage B4 can benefit from TACE.",
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AU - Biolato, Marco

AU - Gallusi, Giulia

AU - Iavarone, Massimo

AU - Cabibbo, Giuseppe

AU - Racco, Simona

AU - De Santis, Adriano

AU - Corte, Cristina Della

AU - Maida, Marcello

AU - Attili, Adolfo Francesco

AU - Sangiovanni, Angelo

AU - Cammà, Calogero

AU - La Torre, Giuseppe

AU - Gasbarrini, Antonio

AU - Grieco, Antonio

PY - 2018/1/1

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N2 - Background and aims. A subclassification system for intermediate hepatocellular carcinoma (HCC) was recently proposed to optimize treatment allocation. The aim of this study was to assess the prognostic ability of that substaging proposal. Patients and methods. This is a retrospective multicenter cohort study including patients with intermediate HCC treated with transarterial chemoembolization (TACE). Predictors of survival were identified using the Cox proportional regression model. Results. 289 Barcelona Clinic Liver Cancer (BCLC) B patients were included. Median overall survival of the whole cohort was 23 months (C.I. 95% 20.2-25.8). Child A status (H.R. 1.35, C.I. 95% 1.02-1.78) and tumour burden beyond the up-to-seven criterion (H.R. 1.39, C.I. 95% 1.07-1.80) were independent prognostic factors for overall survival on multivariate analysis. Analysis of the substages showed that median survival was 33.0 months for B1 stage (n = 81), 20.8 months for B2 stage (n = 106), 16.1 months for B3 stage (n = 24), 22.2 months for B4 stage (n = 42) and 15.0 months for quasi-C stage (n = 36). Regarding the discriminatory ability of the substaging proposal, the log rank test showed a significant survival difference for B1vs. B4 (p = 0.003) and B1 vs. Quasi-C (p = 0.039) and a trend for B1 vs. B2 (p = 0.05) and B1 vs. B3 (p = 0.05). Conclusions. Apart from substage B1, BCLC-B subclassification does not discriminate perfectly patients treated with TACE. Also some patients in substage B4 can benefit from TACE.

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KW - Sorafenib

KW - Staging system

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