Surgical and oncological outcomes of hepatic resection for BCLC-B hepatocellular carcinoma: a retrospective multicenter analysis among 474 consecutive cases

In this study, we focused on surgical and oncological outcomes of hepatic resection in BLCB-B patients. Patients who received hepatic resection for early- (BCLC-0/A) or intermediate-stage (BCLC-B) HCC in two tertiary hepatobiliary centers between January 2003 and December 2016 were included in study. Four-hundred and twenty-nine patients were included in the analysis. At the time of resection, 298 patients were classified as BCLC-A/0 and 131 as BCLC-B. Despite a higher complication rate in BCLC-B group (49.6% vs 32.9%;p = 0.001), the incidence of clinically relevant complications did not differ significantly between the two groups (16.0% vs 10.1%;p = 0.079); moreover, postoperative mortality (4.6% vs 2.7%;p = 0.309) and relapse-free survival (RFS) were similar between BCLC-0/A and BCLC-B group (1-, 3-, and 5-year RFS: 74, 43, and 31% vs 59, 38, and 34%;p = 0.180). Overall survival was slightly worse in BCLC-B group (1-, 3-, and 5-year overall survival of 89, 70, and 52% vs. 77, 51, and 44%;p = 0.004). Focusing on BCLC-B group, a Child–Pugh score B (HR 2.47;p = 0.003), growing number of nodules (HR 3.04;p = 0.003), and R1 resection (HR 2.43;p = 0.005) beard a higher risk of tumor recurrence, while overall survival was negatively affected by the presence of more than two nodules (HR 3.66;p = 0.0001) and R1 resection (HR 3.06;p = 0.0001); patients presenting single-large HCC experienced a better overall survival (HR 0.53;p = 0.014) a...
Source: Updates in Surgery - Category: Surgery Source Type: research