Liver resection is the most effective treatment for hepatocellular carcinoma （HCC）. The Barcelona Clinic Liver Cancer （BCLC） staging system is commonly accepted as a guideline for HCC treatment, but it only recomm...Liver resection is the most effective treatment for hepatocellular carcinoma （HCC）. The Barcelona Clinic Liver Cancer （BCLC） staging system is commonly accepted as a guideline for HCC treatment, but it only recommends liver resection for the patients with HCC at stage 0 to A1. The surgical indications of the BCLC staging system need to be re-evaluated. 120 HCC patients undergoing curative liver resection were retrospectively stratified to the BCLC staging system, and the survival of the patients at stages A, B and C was analyzed. The justification of the BCLC staging system was re-evaluated. Fifty-two patients were classified at stage A, 51 at stage B and 17 at stage C respectively. The hospital mortality of this cohort was zero and the morbidity was 24.1%. The 1-, 2-, 3-year overall survival rate of this cohort was 81.6%, 68.3%, and 57.5% respectively. There was no signifi-cant difference in the survival rate between the patients at stage A and B （P〉0.05）. If the treatment guidelines of BCLC staging system were followed, the majority of the patients at stages A and B （77.7%, 80/103） would not have been treated surgically. Our data suggest that the surgical indications of the BCLC staging system are not justified for HCC treatment. More studies may be needed as for how to further broaden the surgical indications of the BCLC staging system in the future.展开更多
基金supported by grants from the National Natural Science Foundation of China (No. 30772126)the New Century Excellent Talent Foundation of China Ministry of Education (No. NCET-04-0701) to Dr. Zhiyong HUANG+1 种基金by grants from the Chinese Ministry of Public Health for Key Clinical Projects (No. 353, 2007)the Health Department, the Science & Technology Department of Hubei Province for the Clinical Medicine Research Centre of Hepatic Surgery (2007) to Dr. Xiaoping CHEN
文摘Liver resection is the most effective treatment for hepatocellular carcinoma （HCC）. The Barcelona Clinic Liver Cancer （BCLC） staging system is commonly accepted as a guideline for HCC treatment, but it only recommends liver resection for the patients with HCC at stage 0 to A1. The surgical indications of the BCLC staging system need to be re-evaluated. 120 HCC patients undergoing curative liver resection were retrospectively stratified to the BCLC staging system, and the survival of the patients at stages A, B and C was analyzed. The justification of the BCLC staging system was re-evaluated. Fifty-two patients were classified at stage A, 51 at stage B and 17 at stage C respectively. The hospital mortality of this cohort was zero and the morbidity was 24.1%. The 1-, 2-, 3-year overall survival rate of this cohort was 81.6%, 68.3%, and 57.5% respectively. There was no signifi-cant difference in the survival rate between the patients at stage A and B （P〉0.05）. If the treatment guidelines of BCLC staging system were followed, the majority of the patients at stages A and B （77.7%, 80/103） would not have been treated surgically. Our data suggest that the surgical indications of the BCLC staging system are not justified for HCC treatment. More studies may be needed as for how to further broaden the surgical indications of the BCLC staging system in the future.
