Retrospective Cohort Study
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Hepatol. Mar 27, 2015; 7(3): 628-632
Published online Mar 27, 2015. doi: 10.4254/wjh.v7.i3.628
Survival rates according to barcelona clinic liver cancer sub-staging system after transarterial embolization for intermediate hepatocellular carcinoma
Leandro Armani Scaffaro, Steffan Frosi Stella, Mario Reis Alvares-Da-Silva, Cleber Dario Pinto Kruel
Leandro Armani Scaffaro, Radiology Division, Hospital de Clínicas de Porto Alegre, Porto Alegre 90035-903, Brazil
Steffan Frosi Stella, National Institute of Science and Technology for Health Technology Assessment (IATS), Porto Alegre 90035-903, Brazil
Mario Reis Alvares-Da-Silva, Gastroenterology Division, Hospital de Clínicas de Porto Alegre, Porto Alegre 90035-903, Brazil
Cleber Dario Pinto Kruel, Surgery Division, Hospital de Clínicas de Porto Alegre, Porto Alegre 90035-903, Brazil
Author contributions: All author contributed equally to this work.
Ethics approval: The study was reviewed and approved by the Hospital de Clínicas de Porto Alegre Review Board.
Informed consent: Retrospective study with no written informed consent.
Conflict-of-interest: The authors have no conflict of interest to disclosure.
Data sharing: Statistical code, and dataset available from the corresponding author at
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Correspondence to: Leandro Armani Scaffaro, MD, PhD, Radiology Division, Hospital de Clínicas de Porto Alegre, R. Ramiro Barcelos, 2350 sala 1505, Porto Alegre 90035-903, Brazil.
Telephone: +55-51-33598000
Received: October 31, 2014
Peer-review started: November 1, 2014
First decision: December 12, 2014
Revised: January 15, 2015
Accepted: February 10, 2015
Article in press: February 10, 2015
Published online: March 27, 2015

AIM: To investigate the survival rates after transarterial embolization (TAE).

METHODS: One hundred third six hepatocellular carcinoma (HCC) patients [90 barcelona clinic liver cancer (BCLC) B] were submitted to TAE between August 2008 and December 2013 in a single center were retrospectively studied. TAE was performed via superselective catheterization followed by embolization with polyvinyl alcohol or microspheres. The date of the first embolization until death or the last follow-up date was used for the assessment of survival. The survival rates were calculated using the Kaplan-Meier method, and the groups were compared using the log-rank test.

RESULTS: The overall mean survival was 35.8 mo (95%CI: 25.1-52.0). The survival rates of the BCLC A patients (33.7%) were 98.9%, 79.0% and 58.0% at 12, 24 and 36 mo, respectively, and the mean survival was 38.1 mo (95%CI: 27.5-52.0). The survival rates of the BCLC B patients (66.2%) were 89.0%, 69.0% and 49.5% at 12, 24 and 36 mo, respectively, and the mean survival was 29.0 mo (95%CI: 17.2-34). The survival rates according to the BCLC B sub-staging showed significant differences between the groups, with mean survival rates in the B1, B2, B3 and B4 groups of 33.5 mo (95%CI: 32.8-34.3), 28.6 mo (95%CI: 27.5-29.8), 19.0 mo (95%CI: 17.2-20.9) and 13 mo, respectively (P = 0.013).

CONCLUSION: The BCLC sub-staging system could add additional prognosis information for post-embolization survival rates in HCC patients.

Keywords: Hepatocellular carcinoma, Barcelona clinic liver cancer, Transarterial embolization, Subclassification

Core tip: This is the first study to apply the barcelona clinic liver cancer (BCLC) B subclassification in a survival analysis for hepatocellular carcinoma patients after transarterial embolization. Were observed significant differences in the mean survival rates among B1, B2, B3 and B4 patients. The BCLC B sub-staging system could be an additional tool for accessing prognosis in the post-embolization survival rates of hepatocellular carcinoma patients.