Comparison of Survival Rates Based on Recommended Treatment Algorithms of BCLC or HKLC Staging Systems for Hepatocellar Carcinoma Patients

Objective To evaluate the effect of the recommended treatment algorithms of the Barcelona Clinic Liver Cancer (BCLC) or Hong Kong Liver Cancer (HKLC) staging systems on the survival rate of patients with HCC.

Methods A total of 436 patients newly diagnosed as HCC were analyzed. The prognostic performance and efficacy of treatment recommendations were compared between the two systems. All patients were first classified into a tumour stage according to the HKLC and BCLC staging systems respectively, and then they were divided into groups depending on whether they ultimately received the treatment recommended by the two staging systems. The efficacy of treatment algorithms of BCLC and HKLC systems was evaluated by comparing the patients who received treatment recommendations of either BCLC or HKLC stage to those who did not.

Results HCC patients who received the recommended treatment algorithms of the BCLC and HKLC systems had a significantly favourable 5-year survival probability compared with the patients who did not (BCLC: 48% vs. 30%, P < 0.001; HKLC: 41% vs. 29%, P < 0.001). Patients receiving resection had a significantly favourable 5-year survival rate in BCLC-B/HKLC-Ⅰ+Ⅱa+Ⅱb, BCLC-B/HKLC-Ⅲa+Ⅲb and BCLC-C/HKLC-Ⅲa+Ⅲb groups than those receiving TACE, Sorafenib or best supportive care(all P < 0.05).

Conclusion The recommended treatment algorithms of the BCLC and HKLC systems could improve survival rates of HCC patients. Curative therapies are superior to standard of care for BCLC-B/HKLC-Ⅰ+Ⅱa+Ⅱb, BCLC-B/HKLC-Ⅲa+Ⅲb and BCLC-C/HKLC-Ⅲa+Ⅲb patients. Some patients can achieve better survival through active radical treatment.