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Hepatic Resection Provides Survival Benefit for Selected Intermediate-Stage (BCLC-B) Hepatocellular Carcinoma Patients.

Purpose: The intermediate stage of HCC (BCLC B) comprises a highly heterogeneous population, and the treatment strategy is still controversial. Because of the heterogeneity, a subclassification of intermediate-stage HCCs was put forward by Bolondi et al according to the 'beyond Milan and within up-to-7'criteria and Child-Pugh score. In this study, we aim to analyze the prognosis of BCLC B stage HCC patients who received hepatic resection according to the Bolondi's subclassification.

Materials and Methods: 1,103 patients diagnosed with HCC and treated with hepatic resection were enrolled in our hospital between 2006 and 2012. According to Bolondi 's subclassification, the BCLC-B patients were divided into 4 groups. Recurrence-free survival (RFS) and overall survival (OS) were analyzed.

Results: According to Bolondi 's subclassification, the BCLC-B patients were divided into 4 groups: B1 (41,18.7%), B2 (160,73.1%), B3 (11,5.0%) and B4 (7,3.2%). Significant difference was observed between B1 and other groups (B1 Vs. B2: P = 0.0224, B1 Vs. B3: P <0.001, B1 Vs. B4: P <0.001), but no difference for B2 Vs. B4 (P = 0.542) and B3 Vs. B4 (P = 0.542). In addition, no significant differences were observed between BCLC-A and BCLC-B1 group for both RFS (P =0.0865) and OS (P =0.643). In multivariate analysis, BCLC-B subclassification was not a risk factor for both OS (P =0.263) and (P =0.892).

Conclusions: In our study, HCC patients at B1 stage were benefited from hepatic resection and had similar survival to BCLC A stage patients. Our study provided rationality of hepatic resection for selected BCLC B stage HCC patients instead of routine TACE.

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