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

Kikuchi, Luciana; Chagas, Aline Lopes; Alencar, Regiane S. S. M.; Tani, Claudia Megumi; Diniz, Márcio A.; D’Albuquerque, Luiz Augusto Carneiro; Carrilho, Flair José

doi:10.6061/clinics/2017(08)01

Cited by 26 publications

(16 citation statements)

References 21 publications

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“…To consider the risk of liver failure and tumor burden in the terminal stage of HCC, DAA was not prescribed in our general practice; therefore, this stage was excluded. A previous study revealed that the OS in stage D patients was worse in patients adherent to HCC therapy than in nonadherent patients [29]. AASLD guidance recommends that patients with a life expectancy of less than 12 months are unlikely to benefit from HCV eradication and therefore palliative care is suggested [30].…”

Section: Plos Onementioning

confidence: 99%

Impact of direct-acting antiviral therapy for hepatitis C–related hepatocellular carcinoma

Lin

Chang

et al. 2020

PLoS ONE

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With the introduction of direct-acting antiviral (DAA) agents, hepatitis C virus (HCV) treatment has dramatically improved. However, there are insufficient data on the benefits of DAA therapy in hepatocellular carcinoma (HCC). The purpose of this study was to investigate the outcome of patients who received DAA therapy after HCC treatment. We retrospectively reviewed patients with HCV-related HCC in a single medical center, and the outcome of patients with or without DAA therapy was analyzed. In total, 107 HCC patients were enrolled, of whom 60 had received DAA therapy after treatment for HCC. There were no significant intergroup differences in age, sex, laboratory results, or tumor burden. A more advanced stage was noted in the no DAA group (P = 0.003). In the treatment modality, sorafenib was commonly prescribed in the no DAA group (P = 0.007). The DAA group had a longer overall survival (OS) time than the no DAA group (P<0.001). When stratified by Barcelona Clinic Liver Cancer staging, the DAA group had better OS in the HCC stages 0-A and B-C (P = 0.034 and P = 0.006). There were 35 patients who received DAA therapy after curative HCC therapy. At a median follow-up of 20 months, 37.1% patients had HCC recurrence after DAA therapy. There was no statistical difference in recurrence-free survival between patients receiving and those not receiving DAA (P = 0.278). DAA therapy improved the survival outcome of HCC patients and did not increase recurrent HCC after curative therapy.

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Section: Plos Onementioning

confidence: 99%

Impact of direct-acting antiviral therapy for hepatitis C–related hepatocellular carcinoma

Lin

Chang

et al. 2020

PLoS ONE

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“…In this regard, the Barcelona Clinic Liver Cancer (BCLC) classification accomplishes these goals (105) . This system has been extensively used worldwide (106) and in Brazil (1,107) . Importantly, several other classifications are mentioned in American, European, and Asian literature such as TNM, Cancer of the Liver Italian Program (CLIP), Hong Kong Liver Cancer (HKCL), and Japanese Integrated Staging (JIS) score (108)(109)(110)(111) .…”

Section: Staging and Classification For Treatment Allocation: A New Lmentioning

confidence: 99%

Brazilian Society of Hepatology Updated Recommendations for Diagnosis and Treatment of Hepatocellular Carcinoma

Chagas

Mattos

Carrilho

et al. 2020

Arq. Gastroenterol.

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Hepatocellular carcinoma (HCC) is one of the leading causes of cancer-related mortality worldwide. The Brazilian Society of Hepatology (SBH) published in 2015 its first recommendations about the management of HCC. Since then, new data have emerged in the literature, prompting the governing board of SBH to sponsor a single-topic meeting in August 2018 in São Paulo. All the invited experts were asked to make a systematic review of the literature reviewing the management of HCC in subjects with cirrhosis. After the meeting, all panelists gathered together for the discussion of the topics and the elaboration of updated recommendations. The text was subsequently submitted for suggestions and approval of all members of the Brazilian Society of Hepatology through its homepage. The present manuscript is the final version of the reviewed manuscript containing the recommendations of SBH.

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“…Two Latin American studies evaluated adherence to BCLC and its impact on survival. In a study from Brazil, adherence to BCLC did not have a favorable impact on survival[ 25 ]. However, there was a selection bias when “non-adherence” was categorized in those patients within BCLC-D stage who were candidates for liver transplantation.…”

Section: Where Do We Stand In Latin America Regarding Hepatocellular mentioning

confidence: 99%

Hepatocellular carcinoma in Latin America: Diagnosis and treatment challenges

Piñero¹,

Poníachik²,

Ridruejo³

et al. 2018

WJG

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Latin America, a region with a population greater than 600000000 individuals, is well known due to its wide geographic, socio-cultural and economic heterogeneity. Access to health care remains as the main barrier that challenges routine screening, early diagnosis and proper treatment of hepatocellular carcinoma (HCC). Therefore, identification of population at risk, implementation of surveillance programs and access to curative treatments has been poorly obtained in the region. Different retrospective cohort studies from the region have shown flaws in the implementation process of routine surveillance and early HCC diagnosis. Furthermore, adherence to clinical practice guidelines recommendations assessed in two studies from Brazil and Argentina demonstrated that there is also room for improvement in this field, similarly than the one observed in Europe and the United States. In summary, Latin America shares difficulties in HCC decision-making processes similar to those from developed countries. However, a transversal limitation in the region is the poor access to health care with the consequent limitation to standard treatments for overall population. Specifically, universal health care access to the different World Health Organization levels is crucial, including improvement in research, education and continuous medical training in order to expand knowledge and generation of data promoting a continuous improvement in the care of HCC patients.

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

Cited by 26 publications

References 21 publications

Impact of direct-acting antiviral therapy for hepatitis C–related hepatocellular carcinoma

Impact of direct-acting antiviral therapy for hepatitis C–related hepatocellular carcinoma

Brazilian Society of Hepatology Updated Recommendations for Diagnosis and Treatment of Hepatocellular Carcinoma

Hepatocellular carcinoma in Latin America: Diagnosis and treatment challenges

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