Modified BCLC boasts good prognostic capability in HCC patients

Adherence to the modified Barcelona Clinic Liver Cancer (BCLC) treatment guidelines is high in Taiwan, particularly among stage 0 and A hepatocellular carcinoma (HCC) patients, a recent study has found. However, nonadherence was prevalent in the treatment of stage B and C patients.

The researchers retrospectively assessed data from 1,801 consecutive patients (median age 62 years, 73.5 percent men) with de novo HCC. According to BCLC staging, 302 patients were stage 0, 783 were stage A, 242 were stage B, 358 were stage C, and 116 were stage D.

Adherence to the treatment according to the modified BCLC guidelines was high among patients with lower stages of disease. For instance, adherence was 85.8 percent in stage 0 patients and 77.4 percent in stage A patients.

Guidelines were also mostly followed even among stage D patients, in whom adherence was 71.6 percent. However, adherence dropped in stage B and C patients, with corresponding rates of 49.6 percent and 26.0 percent.

The modified BCLC treatment guidelines also showed good prognostic capability. In stage 0 patients, the overall survival (OS) was 77.9 months, which dropped progressively to 67.8, 35, 11, and 3.9 months in those with stage A, B, C, and D disease, respectively. A similar trend was observed when OS rates, rather than median OS time, were assessed.

“[U]sing prospectively collected data, we have validated the prognostic capability of the modified BCLC staging system, which had not previously been prospectively validated,” the researchers said.