Study on the accurate clinical staging method of Barcelona Clinic Liver Cancer stage B and C in hepatocellular carcinoma

Objective:To investigate the accurate clinical substaging of Barcelona Clinic Liver Cancer(BCLC) stage B and C.Methods:A total of 854 intermediate and advanced hepatocellular carcinoma(HCC)patients including 429 cases of BCLC stage B and 425 cases of BCLC stage C were studied.Overall survival and related risk factor in all cases were analyzed,and all patients were substaged.Results:BCLC stage B could be subdivided into the stage B1(tumor size ≤ 5 cm and Child-Pugh A or B),B2(tumor size >5 cm and Child-Pugh A) and B3(tumor size >5cm and Child-Pugh B).BCLC stage C could be subdivided into the stage C1(no portal vein invasion and extra-hepatic metastasis),C2(portal vein invasion or extra-hepatic metastasis) and C3(portal vein invasion and extra-hepatic metastasis).At BCLC stage B patients with tumor diameter ≤ 5 cm,the Child-Pugh staging of liver function did not affect the prognosis.The difference of 1-year survival rate between stage B3 and C1 patients was not statistically significant(P>0.05).Conclusions:The accuracy of BCLC staging in predicting the prognosis of patients with intermediate and advanced HCC is not enough,and the substaging might be useful for determining the prognosis of patient and guiding treatment strategies.