Prognosis of Hepatocellular Carcinoma in Relation to Treatment Across BCLC Stages
Prognosis of Hepatocellular Carcinoma in Relation to Treatment Across BCLC Stages
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DOI：
10.1245/s10434-011-1551-4
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发表时间：
2011-07-01
影响因子：
3.7
通讯作者：
Sangro, Bruno
中科院分区：
文献类型：
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作者：
D'Avola, Delia;Inarrairaegui, Mercedes;Sangro, Bruno
背景资料。巴塞罗那临床肝癌(BCLC)分期系统建议对每个肿瘤阶段进行一线治疗。我们评估了BCLC治疗分配的依从性对肝细胞癌患者预后的影响。我们回顾分析了连续359例新诊断的肝细胞癌患者，这些患者在14年的时间里在我们的肝科接受治疗。根据治疗是否符合BCLC推荐标准，对每个阶段的存活率进行比较。我们还比较了接受不同治疗的同一BCLC期患者和接受相同治疗的不同BCLC期患者的存活率。接受根治性治疗的bclc-A患者(66%)比接受局部或系统治疗的患者(33%)存活时间更长(117vs.20个月；p<；0.001)。接受局部治疗的bclc-B患者的存活率(57%)比接受根治性治疗的患者(32%)短(24个月比71个月；p<；0.001)。接受系统治疗或支持性护理的bclc-C患者的存活期(6个月比11个月；p=0.003)比接受局部治疗的患者(39%)短。接受系统治疗或支持治疗的bclc-d患者的存活率显著低于接受肝移植治疗的患者(5vs.137月；p<；0.001)。除了BCLC分期外，实际治疗决定了肝癌患者的存活率。
Background. The Barcelona Clinic Liver Cancer (BCLC) staging system recommends first-line therapy for each tumor stage. We evaluated the effect of compliance with BCLC treatment allocation on the prognosis of patients with hepatocellular carcinoma (HCC).Methods. We retrospectively analyzed 359 consecutive, newly diagnosed HCC patients treated in our Liver Unit during a 14-year period. For each stage, survival was compared according to whether treatment matched the BCLC recommendation. We also compared the survival of patients in the same BCLC stage who received different treatments, and patients in different BCLC stages receiving the same treatment.Results. BCLC-A patients treated with radical therapies (66%) survived longer (117 vs. 20 months; p < 0.001) than patients (33%) who received locoregional or systemic therapies. Survival of BCLC-B patients treated with locoregional treatments (57%) was shorter (24 vs. 71 months; p < 0.001) than that of patients receiving radical therapies (32%). BCLC-C patients treated with systemic therapy or supportive care survived shorter (6 vs. 11 months; p = 0.003) than those receiving locoregional therapies (39%). Survival of BCLC-D patients receiving systemic therapies or supportive care was significantly lower than that of patients treated by liver transplantation (5 vs. 137 months; p < 0.001).Conclusions. In addition to BCLC stage, actual treatment determines survival in patients with HCC.