Liver, Pancreas and Biliary Tract| Volume 53, ISSUE 2, P210-215, February 2021

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A comparison of factors associated with the temporal improvement in the overall survival of BCLC stage 0 hepatocellular carcinoma patients

Published:November 11, 2020DOI:



      It is uncertain whether the prognosis of Barcelona Clinical Liver Cancer (BCLC) stage 0 hepatocellular carcinoma (HCC) has improved.


      To evaluate whether the outcomes of BCLC stage 0 patients has improved, and if so, what are the reasons behind the noted improved outcome.


      A total of 591 patients with BCLC stage 0 HCC diagnosed at Samsung Medical Center, Seoul, Korea were grouped based on year of diagnosis (earlier cohort; 2007–2009 and later cohort; 2013–2015) and compared.


      The overall survival (OS) was improved for BCLC stage 0 patients at later cohort (5-year survival rate: 82.1% vs. 92.0% for earlier cohort and later cohort, p = 0.015). However, after adjustment, the treatment period was not an independent factor for OS, especially when the albumin-bilirubin (ALBI) grade was adjusted. The incidence of liver cirrhosis (LC)-related death was increased from 10.4% to 33.3%, while the incidence of HCC-related death decreased from 57.5% to 28.6% in the latter cohort.


      The survival improvement of BCLC stage 0 patients was largely explained by better liver function at diagnosis. Mortality from LC-related death was increasing, which calls for careful attention for finding strategies for preserving the liver function for BCLC stage 0 patients.



      HCC (hepatocellular carcinoma), BCLC (Barcelona Clinical Liver Cancer), ECOG (Eastern Cooperative Oncology Group), BMI (body mass index), ALBI (albumin-bilirubin), AFP (alpha-fetoprotein), LC (liver cirrhosis), PH (proportional hazard), OS (overall survival), HR (hazard ratio), CI (confidence index), TACE (trans-arterial chemoembolization)
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