Yefan Zhang, Jianqiang Cai

Department of Abdominal Surgical Oncology, Cancer Hospital & Cancer Institute, Chinese Academy of Medical Sciences

Objective:BCLC staging is one of the most commonly used staging systems with hepatocellular carcinoma patients. According to BCLC staging, the intermedium stage (stage B) patients should be treated with TACE, however in recent years, a growing number of studies found that patients with BCLC B stage could benefit from surgery. Our study was to investigate the prognosis of BCLCB patients treated with surgery and find related risk factors.Method: 365BCLC B stage HCC patients who underwent surgical management in Cancer Institute and Hospital, Chinese Academy of Medical Sciences from 2002 to 2013 were retrospectively analyzed in our study. Survival analysis was performed to evaluate the overall survival (OS) and disease-free survival (DFS). Result: The median follow-up was 26.0(2.0-135.0) months. The median OS was 53.4 months, and the 1-, 3-, 5-year OS were 92.3%, 65.3% and 44.7%; the median DFS was 28.1 months, and the 1-, 3-, 5-year DFS were 68.8%, 44.9% and 33.6%. Univariate survival analysis showed that OS was significantly associated with vascular invasion, multiple lesions, blood loss≥400ml and CEA≥5ng / ml, and DFS with multiple lesions, blood loss≥400ml. Multivariate analysis indicated that multiple lesions, blood loss≥400ml are independent risk factors for both OS and DFS. Conclusion: The majority of patients with BCLC B stage hepatocellular carcinoma can benefit from surgical treatment, and multiple lesions, blood loss≥400ml are independent risk factors for poor prognosis.

Key Words: Hepatocellular carcinoma  BCLC staging Hepatectomy