Abstract
Background
It is uncertain whether the prognosis of Barcelona Clinical Liver Cancer (BCLC) stage
0 hepatocellular carcinoma (HCC) has improved.
Aims
To evaluate whether the outcomes of BCLC stage 0 patients has improved, and if so,
what are the reasons behind the noted improved outcome.
Methods
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.
Results
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.
Conclusions
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.
Keywords
Abbreviations:
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)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: November 11, 2020
Accepted:
October 20,
2020
Received:
July 21,
2020
Identification
Copyright
© 2020 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.
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- Improving prognosis of patients with very early hepatocellular carcinoma: How far are we going?Digestive and Liver DiseaseVol. 53Issue 2
