Clinical Profile and Treatment of Hepatocellular Carcinoma: A Single-Center Experience
| Autor: | Haseeb Haider Zia, Umair Syed Mahmud, Shagufta Zeeshan, Faisal Saud Dar, Atif Rana, Abu Bakar Hafeez H Bhatti, Nusrat Yar Khan, Abdul Ahad Ehsan Sheikh |
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| Rok vydání: | 2021 |
| Předmět: |
Sorafenib
Cancer Research medicine.medical_specialty medicine.medical_treatment Population transarterial chemoembolization Liver transplantation Gastroenterology Internal medicine medicine education RC254-282 education.field_of_study liver transplantation business.industry barcelona clinic liver cancer staging Neoplasms. Tumors. Oncology. Including cancer and carcinogens hepatocellular carcinoma Hepatitis C Hepatitis B medicine.disease Oncology Hepatocellular carcinoma Percutaneous ethanol injection Liver cancer business medicine.drug |
| Zdroj: | South Asian Journal of Cancer, Vol 10, Iss 02, Pp 76-80 (2021) |
| ISSN: | 2278-330X |
| Popis: | Background Very few centers in Pakistan have all established treatments for hepatocellular carcinoma (HCC) available under one roof. With a dedicated hepato-pancreato-biliary surgery and liver transplant unit, we have gathered one of the largest data on HCC in our population. Aims The objective of the current study was to assess the clinical spectrum of HCC in Pakistani patients. Settings and Design This retrospective review of patients diagnosed with HCC was conducted between 2011 and 2016. Materials and Methods Patients were allocated to treatment groups based on the Barcelona clinic liver cancer (BCLC) staging algorithm and our local guidelines. The treatment options were grouped as curative (radiofrequency ablation [RFA], percutaneous ethanol injection [PEI], liver resection, and liver transplantation), palliative (transarterial chemoembolization [TACE]/sorafenib), and the best supportive care (BSC). Statistical Analysis Kaplan–Meier curves were used for the statistical analysis. Results The mean age was 57.9 ± 10.1 years (range: 18–90 years). The male-to-female ratio was (1,099/391) 2.8:1. Hepatitis B and hepatitis C were the most common underlying etiological factor in 1,350 of 1,490 (90.6%) patients. Macrovascular invasion (MVI) was seen in 492 of 1,490 (33%) patients. Out of the total, 191 (12.8%) additional patients were offered potentially curative treatments when compared with BCLC recommendations. The actuarial 5-year overall survival for patients who underwent liver transplant, RFA/PEI, TACE, sorafenib, and BSC was 87, 64, 18, 5, and 0%, respectively. Alpha fetoprotein cut-off of 400 ng/mL had a significant impact on survival irrespective of treatment received (41 vs. 11%, p < 0.0001). Conclusion MVI is the most frequent poor prognostic marker in our patients with HCC. Local treatment guidelines are effective in yielding comparable outcomes to BCLC. |
| Databáze: | OpenAIRE |
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