[Hepatocellular carcinoma in Navarre: study of characteristics and evolution in clinical practice]. / El hepatocarcinoma en la Comunidad Foral de Navarra: estudio de características y evolución en la práctica clínica habitual.

BACKGROUND: Hepatocellular carcinoma generally arises in a cirrhotic liver. The aim of screening is to improve survival. The aims of our study are to determine the characteristics and evolution of hepatocellular carcinoma and the effect of screening on survival, in clinical practice in Navarre. METHODS: Prospective and retrospective study of 111 patients diagnosed with hepatocellular carcinoma in public hospitals in Navarre between January 2009 and January 2015. Epidemiological, clinical, analytical, radiological characteristics, tumour staging, treatment and evolution were analyzed. Survival was compared between patients subjected to screening and those not. RESULTS: Mean age was 67 years. The patients (84.7%) were mainly male and 85.6% had cirrhosis. The most frequent aetiology was alcohol consumption (40.7%). 62.2% were diagnosed in early stages, 15.3% in intermediate and 22.5 % in advanced or terminal stages. 4.5% received transplants, 21.6% received surgical resection, 23.4% were treated with abla-tion techniques, 10.8 % with chemoembolization, 5.4% with radiembolization, 2.7% with embolization, 13.5 % with sorafenib and 18% symptomatically. Only 32 patients (28.8%) were subjected to screening. No statistical differences were found in survival depending on surveillance (32 month versus 34; p = 0.971). CONCLUSIONS: In Navarre, hepatocellular carcinoma generally appears against a background of cirrhosis, and alcohol is the most frequent aetiology. Hepatocellular carcinoma is diagnosed most frequently in early stages and out of screening practi-ces. Screening was not associated to better survival.

El hepatocarcinoma en la Comunidad Foral de Navarra: estudio de características y evolución en la práctica clínica habitual / Hepatocellular carcinoma in Navarre: study of characteristics and evolution in clinical practice

Fundamento: El hepatocarcinoma asienta generalmente sobre una cirrosis hepática. El cribado pretende mejorar la supervivencia. Los objetivos de nuestro trabajo son conocer las características del hepatocarcinoma, su evolución y la influencia del cribado en su supervivencia, en la práctica clínica en Navarra. Material y Métodos: Estudio prospectivo y retrospectivo de 111 pacientes diagnosticados de hepatocarcinoma en hospitales públicos navarros, entre enero de 2009 y enero de 2015. Se analizaron características epidemiológicas, clínicas, analíticas, radiológicas, estadio tumoral, tratamiento y evolución, y el efecto del cribado. Resultados: El 84,7% de los pacientes eran varones. La edad media fue 67 años. El 85,6% tenían cirrosis. La etiología más frecuente fue la enólica (40,7%). El 62,2% se diagnosticó en estadios tempranos, el 15,3% en intermedio y el 22,5% en avanzado o terminal. El 4,5% se trató mediante trasplante, el 21,6% con resección, el 23,4% mediante ablación, el 10,8% con quimioembolización, el 5,4% con radiembolización, el 2,7% con embolización, el 13,5% con sorafenib y el 18% de modo sintomático. Solamente 32 pacientes (28,8%) realizaban cribado. No se han encontrado diferencias significativas en la supervivencia según la realización de cribado (mediana de 32 y 34 meses; p = 0,971). Conclusiones: En Navarra, el hepatocarcinoma se desarrolla generalmente sobre una cirrosis, cuya etiología más frecuente es el consumo de alcohol. El hepatocarcinoma se ha diagnosticado con más frecuencia en estadios iniciales, fuera de cribado. El cribado no ha mejorado la supervivencia (AU)

Background: Hepatocellular carcinoma generally arises in a cirrhotic liver. The aim of screening is to improve survival. The aims of our study are to determine the characteristics and evolution of hepatocellular carcinoma and the effect of screening on survival, in clinical practice in Navarre. Methods: Prospective and retrospective study of 111 patients diagnosed with hepatocellular carcinoma in public hospitals in Navarre between January 2009 and January 2015. Epidemiological, clinical, analytical, radiological characteristics, tumour staging, treatment and evolution were analyzed. Survival was compared between patients subjected to screening and those not. Results: Mean age was 67 years. The patients (84.7%) were mainly male and 85.6% had cirrhosis. The most frequent aetiology was alcohol consumption (40.7%). 62.2% were diagnosed in early stages, 15.3% in intermediate and 22.5 % in advanced or terminal stages. 4.5% received transplants, 21.6% received surgical resection, 23.4% were treated with ablation techniques, 10.8 % with chemoembolization, 5.4% with radiembolization, 2.7% with embolization, 13.5 % with sorafenib and 18% symptomatically. Only 32 patients (28.8%) were subjected to screening. No statistical differences were found in survival depending on surveillance (32 month versus 34; p = 0.971). Conclusions: In Navarre, hepatocellular carcinoma generally appears against a background of cirrhosis, and alcohol is the most frequent aetiology. Hepatocellular carcinoma is diagnosed most frequently in early stages and out of screening practices. Screening was not associated to better survival (AU)