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

Abstract

// Jian-Hong Zhong 1, 2, * , Ning-Fu Peng 1, 2, * , Xue-Mei You 1, 2, * , Liang Ma 1, 2, * , Xiao Xiang 1 , Yan-Yan Wang 1 , Wen-Feng Gong 1, 2 , Fei-Xiang Wu 1, 2 , Bang-De Xiang 1, 2 , Le-Qun Li 1, 2 1 Department of Hepatobiliary Surgery, Affiliated Tumor Hospital of Guangxi Medical University, Nanning 530021, China 2 Guangxi Liver Cancer Diagnosis and Treatment Engineering and Technology Research Center, Nanning 530021, China * These authors have contributed equally to this work Correspondence to: Le-Qun Li, email: xitongpingjia@163.com Bang-De Xiang, email: xiangbangde@gmail.com Keywords: hepatic resection, hepatocellular carcinoma, transarterial chemoembolization, treatment selection, tumor stage Received: December 01, 2016      Accepted: January 18, 2017      Published: February 17, 2017 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.