Background & aims

In 2012, the Barcelona Clinic Liver Cancer (BCLC) system designated a single large hepatocellular carcinoma (SLHCC) (>5 cm) as BCLC stage A rather than stage B. However, a recent study from western countries reported that prognosis following liver resection (LR) among patients with SLHCC was similar to that among patients with BCLC stage B. We aim to evaluate the prognosis following LR among patients with SLHCC from an Asian high-volume liver surgery center.

Methods

Patients who underwent curative-intent LR for histologically proven HCC between 2011 and 2017 were enrolled using an HCC registry database. Overall survival (OS) among patients with BCLC stages 0, A, and B was examined. Patients with a SLHCC were classified as BCLC stage A1.

Results

Among 543 patients, 89 (16.4%) were BCLC stage 0, 289 (53.2%) were BCLC stage A, 92 (16.9%) were BCLC stage A1, and 73 (13.4%) were BCLC stage B. The median follow-up was 38 months. The five-year OS rates among patients with BCLC stages 0, A, A1, and B were 83.5%, 83.7%, 77.4%, and 55.4%, respectively (p<0.001). No difference in OS was noted for patients with BCLC stage A versus A1 (p = 0.11), even after adjusting for competing factors (hazard ratio = 0.97, 95% confidence interval = 0.53–1.79; p = 0.93).

Conclusion

Prognosis following LR among patients with SLHCC was similar to that among patients with BCLC stage A. The prognosis for SLHCC should thus be considered comparable to that for BCLC stage A.

中文翻译：

---

单个大肝细胞癌切除术后的预后：亚洲一家高容量肝脏手术中心的结果。

背景与目标

2012年，巴塞罗那临床肝癌（BCLC）系统将单个大型肝细胞癌（SLHCC）（> 5 cm）指定为BCLC A期而非B期。但是，西方国家的一项最新研究报告说，肝切除术后的预后（ SLHCC患者中的LR）与BCLC B期患者相似。我们旨在评估来自亚洲一家大型肝脏手术中心的SLHCC患者中LR后的预后。

方法

使用HCC注册数据库对2011年至2017年间经组织学证实的HCC进行过治愈性LR的患者入组。检查了BCLC 0，A和B期患者的总生存期（OS）。患有SLHCC的患者被分类为BCLC A1期。

结果

在543例患者中，BCLC 0期患者89例（16.4％），BCLC A期患者289例（53.2％），BCLC A1期患者92例（16.9％），BCLC B期73例（13.4％）。是38个月。BCLC 0，A，A1和B期患者的五年OS率分别为83.5％，83.7％，77.4％和55.4％（p <0.001）。即使调整了竞争因素（BC = 0.97，95％置信区间= 0.53–1.79； p = 0.93），BCLC A期患者与A1期患者的OS也无差异（p = 0.11）。

结论

SLHCC患者的LR预后与BCLC A期的患者相似。因此，SLHCC的预后应被认为与BCLC A期的预后相当。