The results of the treatment of patients with advanced hepatocellular carcinoma in Sverdlovsk region

Autor: V V Petkau, A A Tarkhanov, E A Kiselev
Jazyk: ruština
Rok vydání: 2017
Předmět:
Zdroj: Современная онкология, Vol 19, Iss 1, Pp 75-79 (2017)
Druh dokumentu: article
ISSN: 1815-1434
1815-1442
Popis: The aim is to assess treatment outcomes of patients with advanced hepatocellular cancer (HCC) in daily clinical practice through the example of SHI Sverdlovsk Regional Oncology Dispensary. Materials and methods. The data of regional cancer registry, annual reports of SHI SROD and HCC patients’ medical records were retrospectively studied. 542 patients with stage III and stage IV primary liver cancer applied to outpatient department of SHI SROD in the period of 2011 to 2015. Morphological verification was received in 53 (9.8%) patients. These patients received antitumor treatment: surgery, transarterial chemoembolization (TACE), sorafenib therapy, chemotherapy and the combination of these methods. We examined median overall survival (OS) based on the stage of the process and on tactics. Results. The incidence of malignant neoplasms of the liver has increased in the Sverdlovsk Region over the past 5 years: from 5.58 to 7.6 cases per 100 000 population in men and from 4.93 to 5.1 - in women. Mortality rate has remained at the same level. We determined 82% of patients with stage III and IV HCC. Patients with intermediate-stage (stage B) HCC (n = 21) according to the Barcelona Clinical Liver Cancer staging system underwent surgery (10 patients) or TACE and doxorubicin (11 patients). Median OS was 20.7 and 13.3 months, respectively. Patients with advanced-stage (stage C) HCC (n=32) had undergone surgery before the start of sorafenib therapy (6 patients), TACE (8 patients), TACE plus sorafenib therapy (4 patients) and only sorafenib therapy (4 patients) or cytostatic systemic therapy (10 patients). Median OS was minimum (5.3 months) in the group of patients who had received only chemotherapy. Median OS was maximum (18 months) in sorafenib-treated patients and in patients who had undergone surgery. Conclusions. More than 80% of patients with stage III or IV HCC and with poor general condition usually apply to hospital and thus limiting the possibility of further antitumor treatment. The best approaches to the management of patients with advanced HCC are the combination of methods associated with local effect (surgical treatment and/or TACE) and systemic therapy using such drug as sorafenib.
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