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

Research output: Contribution to journalArticle

Abstract

Prognostic ability of BCLC-B Subclassification in Patients with Hepatocellular Carcinoma Undergoing Transarterial Chemoembolization 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 10 2018

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Keywords

  • Aged
  • Aged, 80 and over
  • Carcinoma, Hepatocellular/mortality
  • Chemoembolization, Therapeutic/adverse effects
  • Decision Support Techniques
  • Female
  • Humans
  • Italy
  • Kaplan-Meier Estimate
  • Liver Neoplasms/mortality
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Neoplasm Staging/methods
  • Predictive Value of Tests
  • Proportional Hazards Models
  • Retrospective Studies
  • Risk Assessment
  • Risk Factors
  • Time Factors
  • Treatment Outcome

Cite this

Biolato, M., Gallusi, G., Iavarone, M., Cabibbo, G., Racco, S., De Santis, A., Corte, C. D., Maida, M., Attili, A. F., 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, 17(1), 110-118. https://doi.org/10.5604/01.3001.0010.7542