Survival of patients with hepatocellular carcinoma in Greece: The past and present and the value of the BCLC system in real-life staging
Journal Title: Αρχεία Ελληνικής Ιατρικής - Year 2014, Vol 31, Issue 4
Abstract
OBJECTIVE To evaluate the survival and characteristics of patients with hepatocellular carcinoma (HCC) in two Greek cohorts, one in the distant past and one in the present, under real-life conditions. METHOD Survival analysis was conducted, retrospectively for 11 patients with HCC diagnosed between 1928 and 1938 (group A), and for 65 patients diagnosed with HCC between 2008 and 2013 (group B). For group B the relevant data were collected partly retrospectively and partly prospectively. The Barcelona Clinic Liver Cancer (BCLC) staging system was used for patients in group B.The characteristics of the patients, the type of treatment, the interim and overall survival and the toxicity of transarterial chemoembolization (TACE) of the tumor and sorafenib were studied. RESULTS Most of the patients with HCC were men. The mean age at diagnosis was 54.3 years in group A and 69.3 years in group B. Mean survival was 3.9 months in group A and 18 months in group B. Chronic hepatitis B (HBV) infection was the commonest risk factor in group B. Nodular HCC was the commonest type of disease in both groups. In most cases the diagnosis was based on dynamic imaging criteria. Targeted biopsy of the lesion was conducted in 16 cases (24.6%). In most patients in group B the cancer was classified as stage A. The median survival for stages A, B, C and D was 26, 24, 18 and 4 months respectively. TACE was undertaken in 38 patients (58.5%), most of who suffered from the postembolization syndrome. Sorafenib was prescribed to 16 patients (24.6%) in group B, the commonest side effects of which were diarrhea, fatigue and hand-foot syndrome. Data analysis from 11 patients (stage A or B at diagnosis) who had received TACE showed no increase in overall survival with sorafenib compared with 11 control subjects (p=0.57). CONCLUSIONS The age at diagnosis and the overall survival of patients with HCC appear to have increased in comparison with 1928−1938. Use of the BCLC system, under real-life conditions, has helped to identify the best available treatment strategy for each patient and improve the prognosis. The toxicity of TACE and sorafenib in the study group was within the predicted range. The data analysis was not sufficiently powerful to detect overall survival benefit in patients with cancer diagnosed as stage A or B according to the BCLC system who received sorafenib after chemoembolization.
Authors and Affiliations
G. NALMPANTIDIS, A. AVGERINOS, I. AVRAMIDIS, D. KAPETANOS, K. IATROU, L. SAKKAS, T. MARIS
Keywords
Related Articles
- EP ID EP136908
- DOI -
- Views 89
- Downloads 0
Measuring the efficiency of Greek public hospitals
OBJECTIVE To examine the performance of Greek public hospitals and to define ways in which inefficient hospitals can increase their ability to manage their resources efficiently. METHOD The sample consisted of 25 gene...
Hydrothorax and spontaneous bacterial empyema in cirrhotic patients
Cirrhotic hydrothorax is defined as a significant pleural effusion in patients with cirrhosis of the liver and no primary cardiopulmonary disease. Its prevalence in patients with decompensated cirrhosis is 4% to 10%. Cir...
Gaucher disease in Greece: Laboratory studies
OBJECTIVE The biochemical and molecular investigation of Gaucher disease in Greece. METHOD Clinically suspect cases over 20 years from all over Greece were studied. The biochemical investigations included assays of ch...
Increased plasma total ghrelin levels in patients with chronic renal failure:<br /> comparison with healthy subjects and relationship with hemodynamic parameters
OBJECTIVE Ghrelin is an orexigenic peptide identified in the stomach as a ligand for the growth hormone secretagogue-receptor. The effect of renal function on plasma ghrelin levels is little known. Recent studies have sh...
Bowel ischemia
No abstract available