Adherence to BCLC recommendations for the treatment of hepatocellular carcinoma: impact on survival according to stage
Clinics
;
72(8): 454-460, Aug. 2017. tab, graf
Artículo
en Inglés
| LILACS
| ID: biblio-890722
ABSTRACT
OBJECTIVES:
This study sought to assess the adherence of newly diagnosed hepatocellular carcinoma patients to the Barcelona Clinic Liver Cancer system treatment guidelines and to examine the impact of adherence on the survival of patients in different stages of the disease.METHODS:
This study included all patients referred for the treatment of hepatocellular carcinoma between 2010 and 2012. Patients (n=364) were classified according to the Barcelona Clinic Liver Cancer guidelines. Deviations from the recommended guidelines were discussed, and treatment was determined by a multidisciplinary team. The overall survival curves were estimated with the Kaplan-Meier method and were compared using the log-rank test.RESULTS:
The overall rate of adherence to the guidelines was 52%. The rate of adherence of patients in each scoring group varied as follows stage 0, 33%; stage A, 45%; stage B, 78%; stage C, 35%; and stage D, 67%. In stage 0/A, adherent patients had a significantly better overall survival than non-adherent patients (hazard ratio=0.19, 95% confidence interval (CI) 0.09-0.42; p<0.001). Among the stage D patients, the overall survival rate was worse in adherent patients than in non-adherent patients (hazard ratio=4.0, 95% CI 1.67-9.88; p<0.001), whereas no differences were observed in patients in stages B or C.CONCLUSIONS:
The rate of adherence to the Barcelona Clinic Liver Cancer staging system in clinical practice varies according to clinical disease stage. Adherence to the recommended guidelines positively impacts survival, especially in patients with early-stage disease.
Texto completo:
Disponible
Índice:
LILACS (Américas)
Asunto principal:
Carcinoma Hepatocelular
/
Adhesión a Directriz
/
Neoplasias Hepáticas
Tipo de estudio:
Guía de Práctica Clínica
/
Estudio observacional
/
Estudio pronóstico
Límite:
Anciano
/
Femenino
/
Humanos
/
Masculino
País/Región como asunto:
America del Sur
/
Brasil
Idioma:
Inglés
Revista:
Clinics
Asunto de la revista:
Medicina
Año:
2017
Tipo del documento:
Artículo
País de afiliación:
Brasil
Institución/País de afiliación:
Universidade de São Paulo/BR
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