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Scripta Scientifica Medica

Management of hepatocellular carcinoma: a study on 240 patients in a single referral center

Irina Ivanova Ivanova, Sonya Banova, Milko Mirchev, Iskren Kotzev, Alexander Zlatarov, Anton Tonev, Nikola Kolev, Svetomir Chakarov, Chavdar Bachvarov, Boyan Balev, Yana Bocheva, Maria Tzaneva

Abstract

Introduction: Hepatocellular carcinoma (HCC) is а leading cause of cancer-related death globally. Our study aimed to provide an understanding of the risk factors, pattern and management of HCC in a real-life practice.

Materials and Methods: Two hundred and forty consecutive patients with HCC were evaluated for an 11-year period (from 2006 to 2016). During the last 5 years the patients were followed up prospectively from the time of the diagnosis to their death.

 Results: A hundred and seventy-two males and 68 females (mean age 66.4 ± 10.3 and 62.4 ± 9.5 years, respectively) were included in the observation. Hepatitis B virus (HBV) infection accounted for 40.4% and hepatitis C virus (HCV) infection – for 25.8% of the aetiology of liver disease. Cirrhosis is a baseline condition in 82%. HCC was found to be a first complication of liver disease in 2/3 of the studied patients. Using Barcelona Clinic Liver Cancer staging system HCC can be categorised as: stage 0 (n=3); stage A (n=32); stage B (n=52); stage C (n=75) and stage D (n=103). Therefore, the prevalence of very early and early HCC was 13%. Radical therapy (resection or ablation) was recommended in 28% of the patients. Importantly, 18 of 55 (32.7%) patients after surgical resection were followed for more than 3 years without tumour relapse. The median survival, based on the main treatment was: 36 months after surgical resection; 24 months after ablation; 10.5 months for patients on Sorafenib; 9.5 months after TACE and only 3 months for palliative care.

 Conclusion: Our study confirms the observed trends in underlying diseases, the heterogeneity of survival and underscores the need of early diagnosis of HCC.


Keywords

Hepatocellular Carcinoma; Hepatitis B; Hepatitis C; Surveillance; Survival

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References

Llovet JM, Lencioni R, Di Bisceglie AM, Gaile PR, Dufour JF, Greten TF, et al. EASL-EORTC clinical practice guidelines: Management of hepatocellular carcinoma. Eur J Cancer. 2012;56(4):908–43.

Heimbach J, Kulik LM, Finn R, Sirlin CB, Abecassis M, Roberts LR, et al. AASLD guidelines for the treatment of hepatocellular carcinoma. Hepatology. 2018;67(1):358-80. doi: 10.1002/hep.29086.

Bruix J, Reig M, Sherman M. Evidence-based diagnosis, staging, and treatment of patients with hepatocellular carcinoma. Gastroenterology. 2016;150(4):836–53. doi: 10.1053/j.gastro.2015.12.041.

Bertuccio P, Turati F, Carioli G, Rodriguez T, La Vecchia C, Malvezzi M, et al. Global trends and predictions in hepatocellular carcinoma mortality. J Hepatol. 2017;67(2):302–9. doi: 10.1016/j.jhep.2017.03.011.

Park J-W, Chen M, Colombo M, Roberts LR, Schwartz M, Chen P-J, et al. Global patterns of hepatocellular carcinoma management from diagnosis to death: the BRIDGE Study. Liver Int. 2015;35(9):2155–66. doi: 10.1111/liv.12818.

Colombo M, Raoul J-L, Lencioni R, Galle PR, Zucman-Rossi J, Banares R, et al. Multidisciplinary strategies to improve treatment outcomes in hepatocellular carcinoma: a European perspective. Eur J Gastroenterol Hepatol. 2013;25(6):639–51. doi: 10.1097/MEG.0b013e32835e33bb.

Abdel-Rahman O. Assessment of the discriminating value of the 8th AJCC stage grouping for hepatocellular carcinoma. Int Hepato-Pancreato-Biliary Assoc. 2018;20(1):41–8. doi: 10.1016/j.hpb.2017.08.017.

Santi V, Buccione D, Di Micoli A, Fatti G, Frigerio M, Farinati F, et al. The changing scenario of hepatocellular carcinoma over the last two decades in Italy. J Hepatol. 2012;56(2):397–405. doi: 10.1016/j.jhep.2011.05.026.

Handziev S. Primary liver cancer. Epidemiology, risk factors and multidisciplinary management. MEDINFO. 2013;(11):1–2.

Kudo M, Matsui O, Izumi N, Iijima H, Kadoya M, Imai Y, et al. JSH consensus-based clinical practice guidelines for the management of hepatocellular carcinoma: 2014 update by the Liver Cancer Study Group of Japan. Liver cancer. 2014;3(3–4):458–68. doi: 10.1159/000343875.

Mazzanti R, Arena U, Tassi R. Hepatocellular carcinoma: Where are we? World J Exp Med. 2016;6(1):21-36. doi: 10.5493/wjem.v6.i1.21.

Tomov B. Primary hepatic cancer in liver cirrhosis. Treatment with transarterial haemoembolization. Ph D Thesis. Sofia, 2016.

Pavlov K, Sotirov D, Genov J, Mitova R. VB. Microwave ablation: monocentric results in treatment of liver neoplasms. Diagnostic Ther Ultrasound. 2017;(2):55–64.




DOI: http://dx.doi.org/10.14748/ssm.v50i2.4441

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About The Authors

Irina Ivanova Ivanova
Clinic of Gastroenterology, St. Marina University Hospital
Bulgaria

Sonya Banova
Clinic of Gastroenterology, St. Marina University Hospital

Milko Mirchev
Clinic of Gastroenterology, St. Marina University Hospital

Iskren Kotzev
Clinic of Gastroenterology, St. Marina University Hospital

Alexander Zlatarov
First Clinic of Surgery, St. Marina University Hospital

Anton Tonev
First Clinic of Surgery, St. Marina University Hospital

Nikola Kolev
First Clinic of Surgery, St. Marina University Hospital

Svetomir Chakarov
Clinic of Imaging Diagnostics, St. Marina University Hospital

Chavdar Bachvarov
Clinic of Imaging Diagnostics, St. Marina University Hospital

Boyan Balev
Clinic of Imaging Diagnostics, St. Marina University Hospital

Yana Bocheva
Clinical Laboratory, St. Marina University Hospital

Maria Tzaneva
Clinic of General and Clinical Pathology, St. Marina University Hospital

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