New Hepatic Resection Criteria for Intermediate-Stage Hepatocellular Carcinoma Can Improve Long-Term Survival: A Retrospective, Multicenter Collaborative Study

Document Type : Research Articles


1 Department of Surgery, Shiga University of Medical Science, Otsu, Japan.

2 Department of Surgery, Kansai Medical University, Hirakata, Japan.

3 Department of General and Gastroenterological Surgery, Osaka Medical College, Takatsuki, Japan.

4 Second Department of Surgery, Wakayama Medical University, Wakayama, Japan.

5 Department of Hepato-Biliary-Pancreatic Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan.

6 Department of Surgery, Nara Medical University, Kashihara, Japan.

7 Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Suita, Japan.

8 Department of Surgery, Faculty of Medicine, Kinki University, Osaka-sasayama, Japan.


Background: Hepatic resection (HR) is not recommended for intermediate-stage hepatocellular carcinoma (HCC) by the Barcelona Clinic Liver Cancer criteria. We examined the prognostic factors of HR for intermediate-stage HCC and developed new HR criteria for intermediate-stage HCC. Methods: A total of 110 patients who underwent HR without any prior treatment for intermediate-stage HCC between January 2007 and December 2012 were enrolled at eight university hospitals. The outcomes and prognostic factors of HR were evaluated to develop new HR criteria. Results: In terms of tumor size and number, the most significant prognostic factors were within the up-to-seven criteria. Furthermore, serum albumin level ≥35 g/L and serum alpha-fetoprotein (AFP) level  


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