Treatment allocation in hepatocellular carcinoma: Assessment of the BCLC algorithm



Document title: Treatment allocation in hepatocellular carcinoma: Assessment of the BCLC algorithm
Journal: Annals of hepatology
Database: PERIÓDICA
System number: 000413425
ISSN: 1665-2681
Authors: 1
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Institutions: 1University of Bern, Inselspital, Berna. Suiza
Year:
Season: Ene-Feb
Volumen: 15
Number: 1
Pages: 82-90
Country: México
Language: Inglés
Document type: Artículo
Approach: Analítico, descriptivo
English abstract Barcelona Clinic Liver Cancer (BCLC) staging system is the algorithm most widely used to manage patients with hepatocellular carcinoma (HCC). We aimed to investigate the extent to which the BCLC recommendations effectively guide clinical practice and assess the reasons for any deviation from the recommendations. Material and methods. Material and methods. The first-line treatments assigned to patients included in the prospective Bern HCC cohort were analyzed. Results. Results. Results. Among 223 patients included in the cohort, 116 were not treated according to the BCLC algorithm. Eighty percent of the patients in BCLC stage 0 (very early HCC) and 60% of the patients in BCLC stage A (early HCC) received recommended curative treatment. Only 29% of the BCLC stage B patients (intermediate HCC) and 33% of the BCLC stage C patients (advanced HCC) were treated according to the algorithm. Eighty-nine percent of the BCLC stage D patients (terminal HCC) were treated with best supportive care, as recommended. In 98 patients (44%) the performance status was disregarded in the stage assignment. Conclusion. Conclusion. The Conclusion. management of HCC in clinical practice frequently deviates from the BCLC recommendations. Most of the curative therapy options, which have well-defined selection criteria, were allocated according to the recommendations, while the majority of the palliative therapy options were assigned to patients with tumor stages not aligned with the recommendations. The only parameter which is subjective in the algorithm, the performance status, is also the least respected
Disciplines: Medicina
Keyword: Gastroenterología,
Oncología,
Terapéutica y rehabilitación,
Carcinoma hepatocelular,
Estadificación,
Escalas de evaluación
Keyword: Medicine,
Gastroenterology,
Oncology,
Therapeutics and rehabilitation,
Hepatocellular carcinoma,
Staging,
Assessment scales
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