Trovato Maria Antonietta, Pesce Antonio, Sofia Maria, Montineri Arturo, Basile Antonio, Palermo Filippo, Fatuzzo Filippo, Nigro Luciano, Puleo Stefano
Hepatogastroenterology. 2013 Oct;60(127):1742-5.
BACKGROUND/AIMS: The Barcelona Clinic Liver Cancer (BCLC) classification has been recently validated as the best system for treatment guidance for hepatocellular carcinoma (HCC). The aim of this retrospective study is to evaluate the usefulness of BCLC in the treatment of HCC comparing our treatment decision and the BCLC algorithm indications.
In 102 patients affected by HCC observed from 1991 to 2002 a retrospective analysis was performed. The choice of treatment was compared with the treatment schedule proposed by BCLC. Whereas the second group of 62 patients observed from 2008 to 2010 was analysed both retrospectively in comparison with the BCLC classification.
We found a disagreement in between our decision making and the choices suggested by BCLC. We only found a statistical significance for age and performance status test. In surgical patients the median age and the PST class were lower with a statistically significant p value (0.04 and 0.03, respectively).
The BCLC system would not have changed our decision either in the past, or in present days, especially in surgical indications. Even if the decision making is affected by BCLC, actually that process still needs the support of the experience of each clinical centre involved.
背景/目的：巴塞罗那临床肝癌（BCLC）分期系统最近被确认为肝细胞癌（HCC）治疗指导的最佳系统。本回顾性研究的目的是通过比较我们的治疗决策与BCLC算法的指征，评估BCLC在HCC治疗中的实用性。
对1991年至2002年观察的102例HCC患者进行回顾性分析。将治疗选择与BCLC提出的治疗方案进行比较。而对2008年至2010年观察的第二组62例患者，与BCLC分期进行回顾性比较分析。
我们发现我们的决策与BCLC建议的选择之间存在分歧。我们仅发现年龄和体能状态测试具有统计学意义。手术患者的中位年龄和PST分级较低，p值具有统计学意义（分别为0.04和0.03）。
BCLC系统无论是在过去还是现在都不会改变我们的决策，尤其是在手术指征方面。即使决策受到BCLC的影响，但实际上该过程仍需要每个参与临床中心的经验支持。
