Prognostic Factors For Patients With Hepatocellular Carcinoma(BCLC B Stage) Who Received Surgical Resection

Background & Aims:The BCLC-staging system is used to facilitate treatment decisions in patients with hepatocellular carcinoma (HCC). Transarterial chemoembolization (TACE) is the recommended standard-of-care for intermediate stage BCLC-B patients, but the intermediate stage of HCC comprises a highly heterogeneous patient population. Moreover,official guidelines have different views on the suitability of hepatic resection (HR) to treat such patients. Domestic and foreign scholars have reported that after the screening of patients with BCLC-B stage HCC, the overall survival time after surgery is better than those receiving TACE. Moreover, official guidelines have different views on the suitability of HR to treat such patients, how to stratifie and give targeted therapies for this part of the patients have not a unified opinion. Therefore, it is important to explore the Prognosis impact of BCLC-B stage HCC patients, and find the right layered approach to select the appropriate treatment therapy for patients with BCLC-B stage HCC.Methods:Six hundred and sixty-six consecutive HCC patients were retrospectively analysed. Patients with stage BCLC-B were grouped according to the proposed subclassification. Baseline patient and tumour characteristics,therapy and overall survival were analysed.Results:The 1-,3- and 5-year overall survival rates after hepatectomy were 75.9%/46.3%/and 39.%, respectively. AST,tumor capsule,tumorous numbers were independent predictors of survival (P< 0.05). The 1-,3- and 5-year disease-free Survival rates after hepatectomy were 44.3%/14.3%and 8.0%, respectively. Multivariate analyses revealed that AST,tumor capsule,tumorous numbers were independent predictors of survival (P< 0.05) in patients with BCLC stage B HCC.Six hundred and sixty-six patients with stage BCLC-B were classified as B1/B2/B3-4 in 158/484 and 24. OS compared between adjacent subgroups (B1 vs. B3-4,B2 vs. B3-4) did not reach statistical significance. Groupwise comparison showed significant differences between B1 vs. B2 (P= 0.029). Cox regression showed no significant influence of the BCLC-B substage on survival.Conclusions:AST, the number of tumors,tumor capsule is an independent risk factor of overall survival time for patients with BCLC B stage HCC after surgery. No significant survival differences between subgroups were found in the retrospective analysis. We could not confirm the BCLC-B subclassification to be prognostically meaningful in our cohort. Further studies in larger collectives with homogenous staging and treatment strategies are warranted to confirm the prognostic significance of the proposed subclassifications.