Distribution Pattern of Barcelona Clinic Liver Cancer Classification Stages in Hepatocellular Carcinoma Patients Treated with Transarterial Chemoembolization

Description

Background. Barcelona Clinic Liver Cancer classification (BCLC) is the most frequently used staging
system for patients with hepatocellular carcinoma (HCC). BCLC is subdivided in five stages (0, A, B, C,
D). Treatment strategy is chosen according to BCLC stage. Transarterial chemoembolization (TACE) is the
standard of care for BCLC stage B patients. Patients with stage 0 – A are usually addressed to ablation, open
resection or liver transplantation, BCLC stage C – systemic chemotherapy, stage D – palliative management. Since introduction of BCLC, numerous studies have been performed for evaluation of TACE also
in BCLC stages A, C and even D. It was clearly shown that in real world studies the management of HCC
frequently deviates from the BCLC recommendations.
Aim. The aim of the study was to evaluate the BCLC stage distribution pattern in HCC patients treated
with TACE.
Methods. This retrospective single centre study enrolled the patients with HCC who received drug-
eluted bead TACE from 2020–2021 in tertiary care hospital. 77 patients were included into the study. All
patients received TACE according to a multidisciplinary tumour board decision. The mean patient age,
gender and BCLC stage was analysed. General performance status was analysed according to Eastern Cooperative Oncology Group (ECOG) classification. Data analysis was performed in MS Office Excel.
Results. The mean age – 68 years (range 52–91), men – 41 (53%), women – 36 (47%). ECOG performance status varied from 0–2. TACE was performed in 38% (n=29) with BCLC stage A, 40% (n=31) –
stage B, 19% (n=15) – stage C, 2% (n=3) – stage D. In stage A 28% (n=8) had multinodular disease (2–3
nodules); 72% (n=21) had a single lesion. In stage C 27% (n=4) of patients had extrahepatic metastasis,
which were managed with open surgery and 73% (n=11) had portal invasion. 2 patients classified into stage
D due to failing liver function (Child-Pugh C), nevertheless, one of them had liver function improvement
after medicamentous treatment.
Conclusion. The results of our study are consistent with literature data and support the real world findings, where TACE is most frequently applied to HCC BCLC stage B, but is also used in other HCC BCLC
stages. This can be explained by variable centre dependent availability of other treatment modalities like
liver transplantation and percutaneous ablation techniques. TACE clearly has an important role in the treatment of HCC as a solitary or combination therapy in each stage of HCC.
Acknowledgements. The authors declare the absence of conflict of interest.

Period	26 Feb 2022
Event title	80th International Scientific Conference of the University of Latvia
Event type	Conference
Conference number	80
Organiser	University of Latvia
Location	Riga, LatviaShow on map
Degree of Recognition	International