Tumor stage and primary treatment of hepatocellular carcinoma at a large tertiary hospital in China: A real-world study

Abstract

The current clinical reality of tumor stages and primary treatments of hepatocellular carcinoma (HCC) is poorly understood. This study reviewed the distribution of tumor stages and primary treatment modalities among a large population of patients with primary HCC. Medical records of patients treated between January 2003 and October 2013 for primary HCC at our tertiary hospital in China were retrospectively reviewed. A total of 6241 patients were analyzed. The distribution of Barcelona Clinic Liver Cancer (BCLC) stages was as follows: stage 0/A, 28.9%; stage B, 16.2%; stage C, 53.6%; stage D, 1.3%. The distribution of Hong Kong Liver Cancer (HKLC) stages was as follows: stage I, 8.4%; stage IIa, 1.5%; stage IIb, 29.0%; stage IIIa, 10.0%; stage IIIb, 33.6%; stage IVa, 3.4%; stage IVb, 2.5%; stage Va, 0.2%; stage Vb, 11.4%. The most frequent therapy was hepatic resection for patients with BCLC-0/A/B disease, and transarterial chemoembolization for patients with BCLC-C disease. Both these treatments were the most frequent for patients with HKLC I to IIIb disease, while systemic chemotherapy was the most frequent first-line therapy for patients with HKLC IVa or IVb disease. The most frequent treatment for patients with HKLC Va/Vb disease was traditional Chinese medicine. In conclusion, Prevalences of BCLC-B and -C disease, and of HKLC I to IIIb disease, were relatively high in our patient population. Hepatic resection and transarterial chemoembolization were frequent first-line therapies.

Controversies of hepatectomy and adjuvant therapy for hepatocellular carcinoma: moving forward

“…In China, about half of HCC patients are diagnosed as HCC in an advanced stage [2] . Many studies compared the safety and efficacy of hepatectomy to transarterial chemoembolization [3,23,24] .…”

“…HBV and HCV infections, alcohol consumption, non-alcoholic steatohepatitis cirrhosis, or obesity pandemic are risk factors of HCC development. A recent survey study found about 70% patients with HCC are diagnosed as intermediate or advanced disease because of the lack of significant syndrome in their early stage [2] . Main treatments of HCC include hepatectomy, liver transplantation, ablation (radiofrequency, microwave, cryoablation), transarterial chemoembolization, radiotherapy, chemotherapy, target therapy, and so on.…”

Comparison of three‐dimensional conformal radiotherapy and hepatic resection in hepatocellular carcinoma with portal vein tumor thrombus

“…Hepatocellular carcinoma (HCC) is very likely to invade the intrahepatic vessel, especially the portal vein, thus forming the portal venous tumor thrombus (PVTT) . It is reported that the incidence of PVTT is 44%‐62.2% . PVTT is one of the important biological characteristics and poor prognostic factors of HCC .…”

“…1 It is reported that the incidence of PVTT is 44%-62.2%. 2 PVTT is one of the important biological characteristics and poor prognostic factors of HCC. 3 Transcatheter arterial chemoembolization (TACE) is one of the most common treatments for advanced HCC patients with PVTT.…”

Timely meta-analysis on the efficacy of adoptive immunotherapy for hepatocellular carcinoma patients after curative therapy

“…Moreover, only a small proportion of patients with HCC are with early stage HCC [2]. Hepatic resection, radiofrequency ablation, and percutaneous ethanol injection are curative treatments for such patients [3].…”