Clinical values of Barcelona Clinic Liver Cancer subgroup and up-to-7 criteria in intermediate stage hepatocellular carcinoma with transcatheter arterial chemoembolization

Shou-Wu Lee; Yen-Chun Peng; Han-Chung Lien; Chung-Wang Ko; Chun-Fang Tung; Chi-Sen Chang

doi:10.12998/wjcc.v10.i21.7275

Clinical values of Barcelona Clinic Liver Cancer subgroup and up-to-7 criteria in intermediate stage hepatocellular carcinoma with transcatheter arterial chemoembolization

World J Clin Cases. 2022 Jul 26;10(21):7275-7284. doi: 10.12998/wjcc.v10.i21.7275.

Authors

Shou-Wu Lee^{1

2

3

4}, Yen-Chun Peng^{1

2}, Han-Chung Lien^{1

2

3}, Chung-Wang Ko^{1

2}, Chun-Fang Tung^{1

2}, Chi-Sen Chang^{1

5}

Affiliations

¹ Division of Gastroenterology and Hepatology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung 40705, Taiwan.
² Department of Internal Medicine, Yang Ming Chiao Tung University, Taipei 112304, Taiwan.
³ Department of Post-Baccalaureate Medicine, College of Medicine, Chung Hsing University, Taichung 40227, Taiwan.
⁴ Department of Internal Medicine, Chung Shan Medical University, Taichung 40201, Taiwan. ericest@vghtc.gov.tw.
⁵ Department of Internal Medicine, Chung Shan Medical University, Taichung 40201, Taiwan.

Abstract

Background: Transarterial chemoembolization (TACE) is a recommended treatment for patients with intermediate stage hepatocellular carcinoma (HCC) but with variable treatment outcomes.

Aim: To determine factors for predicting outcomes of TACE in patients with intermediate stage B HCC.

Methods: Patients with Barcelona Clinic Liver Cancer (BCLC) stage B HCC who underwent TACE as the primary treatment were enrolled at Taichung Veterans General Hospital from January 2005 to December 2009. Patients were assigned to either the objective responder (OR) group or the non-OR group according to mRECIST criteria. Clinical and radiological characteristics were compared between the 2 groups. The overall survival of enrolled subjects was analyzed.

Results: In 128 enrolled patients, 66 (51.6%) were in the OR group and 62 (48.4%) in the non-OR group. Compared with the non-OR group, the OR group had a significantly smaller HCC size (6.55 cm vs 9.50 cm, P = 0.001) and was within the up-to-7 criteria (50% vs 26.7%, P = 0.001). After multivariable analyses, these significant associations still existed. Overall survival rate of all the subjects averaged 20.65 ± 13.26 mo. The survival rate at 1-year was 64.8%, 2-year was 46.9%, and 3-year was 31.2%. For those patients with OR to TACE, smaller tumor size and within up-to-7 criteria were associated with significantly better overall survival. Those patients with subgroup B1 had the highest OR ratio (75%) and better overall survival (26.70 ± 12.07 mo) after TACE.

Conclusion: BCLC stage B HCC patients with smaller tumor size or within up-to-7 criteria had better survival outcomes to TACE. BCLC stage B subgroup is useful to predict refractoriness to TACE.

Keywords: Barcelona Clinic Liver Cancer; Hepatocellular carcinoma; Objective response; Overall survival; Transcatheter arterial chemoembolization.