Africa Guidelines for Hepatocellular Carcinoma Buildup Process.

Autor:	Abou-Alfa GK; Memorial Sloan Kettering Cancer Center, New York, NY.; Weill Medical College at Cornell University, New York, NY.; Trinity College Dublin, Dublin, Ireland., Afihene M; Signetcare Medical Services, Kumasi, Ghana., Capanu M; Memorial Sloan Kettering Cancer Center, New York, NY.; Weill Medical College at Cornell University, New York, NY., Li Y; Memorial Sloan Kettering Cancer Center, New York, NY.; Weill Medical College at Cornell University, New York, NY., Chou JF; Memorial Sloan Kettering Cancer Center, New York, NY., Asombang A; Massachusetts General Hospital, Harvard Medical School, Boston, MA., Alatise OI; College of Health Sciences, Obafemi Awolowo University, Ife-Ife, Nigeria., Bounedjar A; University Blida 1 Laboratoire de Cancérologie, Faculté de Médecine, Blida, Algeria., Cunha L; Hospital Privado De Maputo, Maputo, Mozambique., Mekonnen HD; St.Paul's Hospital Millenium Medical College, Addis Ababa, Ethiopia., Diop PS; Université Cheikh Anta DIOP, Dakkar, Senegal., Elwakil R; Ain Shams University, Cairo, Egypt., Ali MM; L'Hôpital Général de Référence Nationale, Ndjamena, Chad., Ndlovu N; University of Zimbabwe College of Health Sciences, Harare, Zimbabwe., Ndumbalo J; Ocean Road Cancer Institute, Dar es Salaam, Tanzania., Makondi PT; Kamuzu Central Hospital - National Cancer Center, Mzuzu, Malawi., Tzeuton C; Université de Douala, Douala, Cameroon., Biachi de Castria T; Memorial Sloan Kettering Cancer Center, New York, NY.; Moffitt Cancer Center, Tampa, FL., Agyei-Nkansah AA; School of Medicine and Dentistry, Accra, Ghana., Balogun F; Memorial Sloan Kettering Cancer Center, New York, NY.; Weill Medical College at Cornell University, New York, NY., Bougouma A; Université de Ouagadougou UFR/SDS, Ouagadougou, Burkina Faso., Atipo Ibara BI; Marien Ngouabi University, Brazzaville, Republic of the Congo., Jonas E; University of Cape Town and Groote Schuur Hospital, Cape Town, South Africa., Kimani S; University of Utah, Salt Lake City, UT., Kingham P; Memorial Sloan Kettering Cancer Center, New York, NY.; Weill Medical College at Cornell University, New York, NY., Kurrimbukus R; Jeetoo Hospital and Bruno Cheong Hospital, Port Louis, Mauritius., Hammad N; Kingston General Hospital, Kingston, ON, Canada., Fouad M; University of Alabama Birmingham, Birmingham, AL., El Baghdady N; The British University in Egypt, Cairo, Egypt., Servais Albert Fiacre EB; Douala Medical School, Douala, Cameroon., Sewram V; Stellenbosch University, Cape Town, South Africa., Spearman CW; University of Cape Town and Groote Schuur Hospital, Cape Town, South Africa., Yang JD; Cedars-Sinai Medical Center, Los Angeles, CA., Roberts LR; Mayo Clinic, Rochester, MN., Abdelaziz AO; University of Cairo, Cairo, Egypt.
Jazyk:	angličtina
Zdroj:	JCO global oncology [JCO Glob Oncol] 2023 Sep; Vol. 9, pp. e2300159.
DOI:	10.1200/GO.23.00159
Abstrakt:	Purpose: Hepatocellular carcinoma (HCC), the fourth most common cancer in Africa, has a dismal overall survival of only 3 months like in sub-Saharan Africa. This is affected by the low gross domestic product and human development index, absence of coherent guidelines, and other factors. Methods: An open forum for HCC-experienced health care workers from Africa and the rest of the world was held in October 2021. Participants completed a survey to help assess the real-life access to screening, diagnoses, and treatment in the North and Southern Africa (NS), East and West Africa (EW), Central Africa (C), and the rest of the world. Results: Of 461 participants from all relevant subspecialties, 372 were from Africa. Most African participants provided hepatitis B vaccination and treatment for hepatitis B and C. More than half of the participants use serum alpha-fetoprotein and ultrasound for surveillance. Only 20% reported using image-guided diagnostic liver biopsy. The Barcelona Clinic Liver Cancer is the most used staging system (52%). Liver transplant is available for only 28% of NS and 3% EW. C reported a significantly lower availability of resection. Availability of local therapy ranged from 94% in NS to 62% in C. Sorafenib is the most commonly used systemic therapy (66%). Only 12.9% reported access to other medications including immune checkpoint inhibitors. Besides 42% access to regorafenib in NS, second-line treatments were not provided. Conclusion: Similarities and differences in the care for patients with HCC in Africa are reported. This reconfirms the major gaps in access and availability especially in C and marginally less so in EW. This is a call for concerted multidisciplinary efforts to achieve and sustain a reduction in incidence and mortality from HCC in Africa.
Databáze:	MEDLINE
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