Abstract
Introduction: Barcelona Clinic Liver Cancer (BCLC) stage B, an intermediate stage, includes various conditions of hepatocellular carcinoma (HCC). This heterogeneity of the patients with intermediate-stage HCC makes it difficult to predict their survival rates. In the present study, we examined the validity of the modified Bolondi classification (Kinki criteria) as a subclassification of patients with BCLC stage B HCC. Methods: Of 906 patients who underwent conventional transarterial chemoembolization at Kinki University Hospital, 753, who met the inclusion criteria, were examined. Of these 753 patients, 425 (56.4%) with BCLC stage B were subclassified using the Kinki criteria to examine the survival rate. Results: According to the Kinki criteria, 158 (37.2%) were subclassified into subclass B1, 236 (55.5%) into B2, and 31 (7.3%) into B3. The comparison of the survival rates showed that the median overall survival was 3.9 years (95% CI, 3.2-4.6) in the BCLC subclass B1 group, 2.5 years (95% CI, 2.2-3.1) in the B2 group, and 1.1 years (95% CI, 0.6-1.5) in the B3 group (p < 0.001). Conclusion: When the BCLC stage B patients were subclassified according to the Kinki criteria, survival curves were stratified with significant differences, suggesting that the Kinki criteria were suitable for the subclassification of the intermediate-stage HCC patients.
Journal Section:
Clinical Study
References
1.
International Agency for Research on Cancer: GLOBOCAN 2012: estimated cancer incidence, mortality and prevalence worldwide in 2012. http://globocan.iarc.fr/Default.aspx.
2.
Kudo M: Surveillance, diagnosis, treatment, and outcome of liver cancer in Japan. Liver Cancer 2015;4:39-50.
[PubMed]
3.
Llovet JM, Bru C, Bruix J: Prognosis of hepatocellular carcinoma: the BCLC staging classification. Semin Liver Dis 1999;19:329-338.
[PubMed]
4.
Kudo M: Recent advances in bioinformatics reveal the molecular heterogeneity of hepatocellular carcinoma. Liver Cancer 2014;3:68-70.
[PubMed]
5.
Bruix J, Sala M, Llovet JM: Chemoembolization for hepatocellular carcinoma. Gastroenterology 2004;127:S179-S188.
[PubMed]
6.
Lencioni R: Chemoembolization in patients with hepatocellular carcinoma. Liver Cancer 2012;1:41-50.
[PubMed]
7.
Lin S, Hoffmann K, Schemmer P: Treatment of hepatocellular carcinoma: a systematic review. Liver Cancer 2012;1:144-158.
[PubMed]
8.
Bruix J, Sherman M: Management of hepatocellular carcinoma: an update. Hepatology 2011;53:1020-1022.
[PubMed]
9.
European Association for the Study of the Liver; European Organisation for Research and Treatment of Cancer: EASL-EORTC clinical practice guidelines: management of hepatocellular carcinoma. J Hepatol 2012;56:908-943.
[PubMed]
10.
Kudo M, Izumi N, Kokudo N, et al: Management of hepatocellular carcinoma in Japan: Consensus-Based Clinical Practice Guidelines proposed by the Japan Society of Hepatology (JSH) 2010 updated version. Dig Dis 2011;29:339-364.
[PubMed]
11.
Lencioni R: Chemoembolization for hepatocellular carcinoma. Semin Oncol 2012;39:503-509.
[PubMed]
12.
Minami Y, Yagyu Y, Murakami T, Kudo M: Tracking navigation imaging of transcatheter arterial chemoembolization for hepatocellular carcinoma using three-dimensional cone-beam CT angiography. Liver Cancer 2014;3:53-61.
[PubMed]
13.
Kokudo N: Recent progress in the treatment and diagnosis of hepatocellular carcinoma. Liver Cancer 2013;2:4.
14.
Kudo M, Matsui O, Izumi N, et al: JSH Consensus-Based Clinical Practice Guidelines for the management of hepatocellular carcinoma: 2014 update by the Liver Cancer Study Group of Japan. Liver Cancer 2014;3:458-468.
[PubMed]
15.
Raoul JL, Gilabert M, Piana G: How to define transarterial chemoembolization failure or refractoriness: a European perspective. Liver Cancer 2014;3:119-124.
[PubMed]
16.
Bolondi L, Burroughs A, Dufour JF, et al: Heterogeneity of patients with intermediate (BCLC B) hepatocellular carcinoma: proposal for a subclassification to facilitate treatment decisions. Semin Liver Dis 2012;32:348-359.
[PubMed]
17.
Weinmann A, Koch S, Sprinzl M, et al: Survival analysis of proposed BCLC-B subgroups in hepatocellular carcinoma patients. Liver Int 2015;35:591-600.
[PubMed]
18.
Wang JH, Kee KM, Lin CY, et al: Validation and modification of a proposed substaging system for patients with intermediate hepatocellular carcinoma. J Gastroenterol Hepatol 2015;30:358-363.
[PubMed]
19.
Yamakado K, Miyayama S, Hirota S, et al: Subgrouping of intermediate-stage (BCLC stage B) hepatocellular carcinoma based on tumor number and size and Child-Pugh grade correlated with prognosis after transarterial chemoembolization. Jpn J Radiol 2014;32:260-265.
[PubMed]
20.
Yamakado K, Miyayama S, Hirota S, et al: Prognosis of patients with intermediate-stage hepatocellular carcinomas based on the Child-Pugh score: subclassifying the intermediate stage (Barcelona Clinic Liver Cancer stage B). Jpn J Radiol 2014;32:644-649.
[PubMed]
21.
Mazzaferro V, Llovet JM, Miceli R, et al: Predicting survival after liver transplantation in patients with hepatocellular carcinoma beyond the Milan criteria: a retrospective, exploratory analysis. Lancet Oncol 2009;10:35-43.
[PubMed]
22.
Kudo M, Arizumi T, Ueshima K, et al: Subclassification of BCLC B stage hepatocellular carcinoma and treatment strategies: proposal of modified Bolondi's subclassification (Kinki criteria). Dig Dis 2015;33:751-758.
[PubMed]
23.
Murakami T, Tsurusaki M: Hypervascular benign and malignant liver tumors that require differentiation from hepatocellular carcinoma: key points of imaging diagnosis. Liver Cancer 2014;3:85-96.
[PubMed]
24.
Ichikawa T, Sano K, Morisaka H: Diagnosis of pathologically early HCC with EOB-MRI: experiences and current consensus. Liver Cancer 2014;3:97-107.
[PubMed]
25.
Kudo M: Clinical practice guidelines for hepatocellular carcinoma differ between Japan, United States, and Europe. Liver Cancer 2015;4:85-95.
[PubMed]
26.
Kudo M, Osaki Y, Matsunaga T, et al: Hepatocellular carcinoma in Child-Pugh C cirrhosis: prognostic factors and survival benefit of nontransplant treatments. Dig Dis 2013;31:490-498.
[PubMed]
© 2015 S. Karger AG, Basel
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