Adherence to BCLC recommendations for the treatment of hepatocellular carcinoma: impact on survival according to stage

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dc.contributorSistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSP
dc.contributor.authorKIKUCHI, Luciana
dc.contributor.authorCHAGAS, Aline Lopes
dc.contributor.authorALENCAR, Regiane S. S. M.
dc.contributor.authorTANI, Claudia
dc.contributor.authorDINIZ, Marcio A.
dc.contributor.authorD'ALBUQUERQUE, Luiz A. C.
dc.contributor.authorCARRILHO, Flair Jose
dc.date.accessioned2017-12-12T13:16:46Z
dc.date.available2017-12-12T13:16:46Z
dc.date.issued2017
dc.description.abstractOBJECTIVES: 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.
dc.description.indexMEDLINE
dc.description.sponsorshipAlves de Queiroz Family Fund for Research
dc.identifier.citationCLINICS, v.72, n.8, p.454-460, 2017
dc.identifier.doi10.6061/clinics/2017(08)01
dc.identifier.eissn1980-5322
dc.identifier.issn1807-5932
dc.identifier.urihttps://observatorio.fm.usp.br/handle/OPI/24267
dc.language.isoeng
dc.publisherHOSPITAL CLINICAS, UNIV SAO PAULO
dc.relation.ispartofClinics
dc.rightsopenAccess
dc.rights.holderCopyright HOSPITAL CLINICAS, UNIV SAO PAULO
dc.subjectHepatocellular Carcinoma
dc.subjectPrognosis
dc.subjectTumor Staging
dc.subjectGuideline Adherence
dc.subject.otherclinical-practice
dc.subject.othermanagement
dc.subject.otherguidelines
dc.subject.otherexperience
dc.subject.otheroutcomes
dc.subject.wosMedicine, General & Internal
dc.titleAdherence to BCLC recommendations for the treatment of hepatocellular carcinoma: impact on survival according to stage
dc.typearticle
dc.type.categoryoriginal article
dc.type.versionpublishedVersion
dspace.entity.typePublication
hcfmusp.author.externalDINIZ, Marcio A.:Univ Sao Paulo, Fac Med, Hosp Clin HCFMUSP,Dept Gastroenterol, Inst Canc Estado Sao Paulo,Sao Paulo Clin Liver C, Sao Paulo, SP, Brazil
hcfmusp.citation.scopus21
hcfmusp.contributor.author-fmusphcLUCIANA OBA ONISHI KIKUCHI
hcfmusp.contributor.author-fmusphcALINE LOPES CHAGAS
hcfmusp.contributor.author-fmusphcREGIANE SARAIVA DE SOUZA MELO ALENCAR
hcfmusp.contributor.author-fmusphcCLAUDIA MEGUMI TANI
hcfmusp.contributor.author-fmusphcLUIZ AUGUSTO CARNEIRO D ALBUQUERQUE
hcfmusp.contributor.author-fmusphcFLAIR JOSE CARRILHO
hcfmusp.description.beginpage454
hcfmusp.description.endpage460
hcfmusp.description.issue8
hcfmusp.description.volume72
hcfmusp.origemWOS
hcfmusp.origem.pubmed28954003
hcfmusp.origem.scieloSCIELO:S1807-59322017000800454
hcfmusp.origem.scopus2-s2.0-85030174826
hcfmusp.origem.wosWOS:000411803900001
hcfmusp.publisher.citySAO PAULO
hcfmusp.publisher.countryBRAZIL
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Artigos e Materiais de Revistas Científicas - HC/ICESP
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