Multicenter Clinical Study Of Barcelona Clinic Liver Cancer Stage C Hepatocellular Carcinoma Patients Treated With Sorafenib

Objective HCC is one of the most common cancer, according to the BCLC staging system.the first line treatment for this stage is sorafinib. PVTT and ES are two related factors that diagnoses advanced hepatocellular carcinoma.The two factors may affect the treatment and prognosis of patients.This study mainly discusses patients survival according to the type of PVTT and the type of ES,and to examine the feasibility of sub-classifition of BCLC stage C. Methods In total 149 patients were included in this study, age:55± 9 years, male 135 cases(90.6%), 114 with hepatitis B(76.5%). 66 patients involve only PVTT, 49 patients involve only ES, 34 patients with PVTT and ES; PVTT were divided into 4 types, type I:sectoral or segmental PVTT; type II: left and/or right main PVTT; type III: main portal vein tumor thrombosis; type?: superior mesenteric vein or inferior vena cava tumor thrombosis; ES were classified into :1?distant metastasis;2?lymph node metastasis; Then BCLC C stage patients were sub-classified into C1: type I and type II?with or without lymph node metastasis; C2: type I and/or type II?with distant metastasis; C3: type III?with or without lymph node metastasis; C4: type III with distant metastasis; Results The mOS was 7.3 months in patients with advanced HCC. The mOS of patients prognosis according to the PVTT was:type ?(10.4 months);type ?(6.0 months);type ?(4.4 months); The mOS with lymph node positive was 12.5 months, which was obviously extended than that of patients with distant;The mOS of patients in sub-stage C1(9.3 months) was significantly longer than the median survival of patients in sub-stage C2(7.0 months), sub-stage C3( 4.3 months), and sub-stage C4( 4.3 months). Conclusions The patients with simple extrahepatic metastasis patients is superior to that of simple portal vein tumor thrombus one; The patients with simple lymph node metastasis in patients with curative effect is better than that of other liver metastasis patients; The patients with left and/or right main or sectoral or segmental portal vein tumor thrombus, patients with lymph node metastasis is better than that of other liver metastasis patients; portal vein tumor thrombus involving the trunk and the type of extrahepatic metastasis had no effect on the prognosis.