New Hepatic Resection Criteria for Intermediate-Stage Hepatocellular Carcinoma Can Improve Long-Term Survival: A...

Area of Science:

• Hepatobiliary Surgery
• Surgical Oncology
• Hepatocellular Carcinoma Research

Background:

• Barcelona Clinic Liver Cancer (BCLC) criteria do not recommend hepatic resection (HR) for intermediate-stage hepatocellular carcinoma (HCC).
• Current guidelines limit surgical options for HCC patients at this stage.
• There is a need to re-evaluate criteria for HR in intermediate-stage HCC.

Purpose of the Study:

• To identify prognostic factors for hepatic resection in intermediate-stage HCC.
• To develop novel criteria for selecting intermediate-stage HCC patients who may benefit from HR.

Main Methods:

• Retrospective analysis of 110 patients with intermediate-stage HCC who underwent HR.
• Data collected from January 2007 to December 2012 across eight university hospitals.
• Evaluation of outcomes and prognostic factors to inform new HR criteria.

Main Results:

• Tumor size and number were significant prognostic factors, aligning with the 'up-to-seven' criteria.
• Serum albumin level (≥35 g/L) and serum alpha-fetoprotein (AFP) level were also identified as key prognostic indicators.
• These factors collectively contribute to predicting outcomes after HR in this patient cohort.

Conclusions:

• The 'up-to-seven' criteria, combined with specific serum albumin and AFP levels, can refine patient selection for HR in intermediate-stage HCC.
• These findings suggest that HR could be a viable option for a carefully selected group of intermediate-stage HCC patients.
• Development of new criteria may expand treatment options beyond current BCLC recommendations for HCC.