Published online Nov 28, 2022. doi: 10.3748/wjg.v28.i44.6271
Peer-review started: August 6, 2022
First decision: September 26, 2022
Revised: October 9, 2022
Accepted: November 9, 2022
Article in press: November 9, 2022
Published online: November 28, 2022
Processing time: 110 Days and 9 Hours
Emerging studies have shown that Barcelona Clinic Liver Cancer (BCLC) intermediate-stage hepatocellular carcinoma (HCC) patients had a good prognosis after liver resection (LR), but the subgroups of BCLC-B patients more suitable for LR have yet to be defined.
There is a lack of studies on whether the sum of tumor size and number (N + S) can be used to select BCLC-B patients who are more suitable for LR. The effect of recurrence patterns on long-term survival in BCLC-B patients undergoing LR is also poorly explored.
The present study aimed to identify BCLC-B patients more suitable for LR and to further analyze the reasons why these patients could benefit from LR.
BCLC stage A or B multinodular HCC (MNHCC) patients undergoing curative hepatectomy were enrolled. Overall survival (OS), recurrence-free survival (RFS), recurrence-to-death survival (RTDS), recurrence patterns, and treatments after recurrence in BCLC-B patients in each subgroup according to N + S were compared with those in BCLC-A patients.
N + S could predict not only the OS and RFS in BCLC-B HCC patients undergoing hepatectomy, but also the recurrence patterns and RTDS in these patients. BCLC-B patients with N + S ≤ 10 had mild recurrence patterns, good RTDS and excellent OS similar to those in BCLC-A MNHCC patients.
N + S can be used to select BCLC-B HCC patients who are more suitable for LR, and LR should be considered in BCLC-B patients with N + S ≤ 10.
As a measure that can be easily obtained and calculated in clinical practice, N + S can help with the clinical decision-making in the treatment of BCLC-B HCC patients.