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KMID : 1039320160160010017
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Journal of Liver Cancer
2016 Volume.16 No. 1 p.17 ~ p.22
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Subclassification of Hepatocellular Carcinoma with Barcelona Clinic Liver Cancer Intermediate Stage
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이혜원:Lee Hye-Won
김승업:Kim Seung-Up/박준용:Park Jun-Yong/김도영:Kim Do-Young/안상훈:Ahn Sang-Hoon/한광협:Han Kwang-Hyub/김범경:Kim Beom-Kyung
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Abstract
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Background/Aims: Hepatocellular carcinoma (HCC) with Barcelona Clinic Liver Cancer (BCLC) intermediate stage includes a highly heterogeneous population. Here, we aimed to subclassify hepatocellular carcinoma with BCLC intermediate stage for better prognostification.
Methods: Between 2003 and 2008, 325 patients who were newly diagnosed as HCC with BCLC intermediate stage were considered eligible. Tumor factor and liver function were used for sub-classification. Overall survival (OS) was analyzed using Kaplan-Meier method with a comparison by log-rank test.
Results: A total of 325 patients with intermediate stage HCC were analyzed. Patients with tumor size ≥7 cm, tumor number ≥4 and Child-Pugh class B had the worse OS compared to those with tumor size <7 cm, tumor number <4 and Child-pugh class A, respectively (all P<0.05). These three variables affected the OS independently from multivariate Cox regression analysis (all P<0.05). So, using these three variables, patients were finally sub-classified as those with fulfilling none of three factors (B-a), one of three factors (B-b), two of three factors (B-c) and all of three factors (B-d) with the median OS of 39.2, 20.6, 12.0 and 8.3 months with statistical significances (all P<0.05 between B-a and B-b, between B-b and B-c, and between B-c and B-d), respectively.
Conclusions: Sub-classification of HCC with BCLC intermediate stage may be useful in not only prognostification but also guidance of treatment strategies.
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KEYWORD
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Hepatocellular carcinoma, Sub-classification, Prognosis, Barcelona Clinic Liver Cancer Stage, Intermediate
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