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Seven centimeters as an optimal cutoff value for prognosis stratification in large monofocal hepatocellular carcinoma

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A Correction to this article was published on 16 February 2023

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Abstract

Purpose

Barcelona Clinic Liver Cancer (BCLC) guidelines designate monofocal hepatocellular carcinoma (HCC) > 2 cm as BCLC A, and large monofocal HCC is defined at > 5 cm. We aimed to evaluate the optimal cutoff value for large monofocal HCC based on prognosis stratification.

Methods

From 2011 to 2018, 3055 patients with newly diagnosed HCC, who were managed in our institution, including 868 patients with monofocal HCC > 2 cm and 330 patients with BCLC B, were enrolled in this retrospective study.

Results

Monofocal HCC > 5 cm patients had worse overall survival (OS) than monofocal HCC 2–5 cm patients (5-year OS: 54% vs. 57%; p = 0.047), confirmed by multivariate analysis (hazard ratio (HR): 1.492, 95% confidence interval (CI): 1.055–2.110; p = 0.024). Monofocal HCC > 5 cm patients had better OS than BCLC B HCC patients (5-year OS: 54% vs. 25%; p < 0.001), confirmed by multivariate analysis (HR: 0.670, 95% CI: 0.481–0.934; p = 0.018). Using 7 cm as the monofocal HCC cutoff value resulted in worse OS than monofocal HCC 2–7 cm (5-year OS: 50% vs. 57%; p = 0.02), confirmed by multivariate analysis (HR: 1.625, 95% CI: 1.039–2.540; p = 0.033). Monofocal HCC > 7 cm patients had better OS than BCLC B patients (p = 0.006). However, no significant difference was identified in the multivariate analysis (HR: 0.726; 95% CI: 0.473–1.115; p = 0.144).

Conclusions

The prognosis of monofocal HCC > 7 cm was similar to that of BCLC B, indicating that 7 cm represents an optimal cutoff value for prognosis stratification in large monofocal HCC.

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Acknowledgements

The authors thank Cancer Center, Kaohsiung Chang Gung Memorial Hospital for the provision of HCC registry data. The authors thank Chih-Yun Lin and Nien-Tzu Hsu and the Biostatistics Center, Kaohsiung Chang Gung Memorial Hospital for statistics work.

Funding

This study was supported by Grant CMRPG8L0181 from the Chang Gung Memorial Hospital-Kaohsiung Medical Center, Taiwan.

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Authors and Affiliations

  1. Division of Hepatogastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, 123 Ta Pei Road, Kaohsiung, Taiwan

    Yi-Hao Yen, Kwong-Ming Kee, Sheng-Nan Lu, Chao-Hung Hung & Tsung-Hui Hu

  2. Liver Transplantation Center and Department of Surgery, Kaohsiung Chang Gung Memorial Hospital, 123 Ta Pei Road, Kaohsiung, Taiwan

    Wei-Feng Li, Chih-Chi Wang & Yueh-Wei Liu

  3. Liver Transplantation Center, Department of Diagnostic Radiology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan

    Yu-Fan Cheng

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  1. Yi-Hao Yen
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Contributions

YHY and CCW involved in study concept and design. All authors involved in acquisition of data. YHY and CCW involved in analysis and interpretation of data. YHY and CCW involved in drafting the manuscript. All authors performed critical revision of the manuscript for an important intellectual content. YHY performed statistical analysis. All authors involved in study supervision. All authors approved the final version of manuscript.

Corresponding authors

Correspondence to Yi-Hao Yen or Chih-Chi Wang.

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Ethics approval and consent to participate

The Institutional Review Board of Kaohsiung Chang Gung Memorial Hospital approved this study (Reference number: 202000398B0) and waived the need for informed consent.

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The authors declare no competing interests.

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Yi-HaoYen and Chih-Chi Wang contributed equally to this work.

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Yen, YH., Li, WF., Kee, KM. et al. Seven centimeters as an optimal cutoff value for prognosis stratification in large monofocal hepatocellular carcinoma. Langenbecks Arch Surg 408, 12 (2023). https://doi.org/10.1007/s00423-023-02753-3

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