Demographic, Clinical and Treatment Characteristics of Patients with Hepatocellular Cancer: 10 Years of Experience of a Single Center

Yıl 2023, Cilt: 10 Sayı: 3, 186 - 190, 19.12.2023

Ezgi Avanaz , Dinç Dinçer , Ali Avanaz , Gülsüm Özlem Elpek , Esra Çobankent Aytekin , Erdem Ayık

https://doi.org/10.47572/muskutd.1352879

Öz

Primary cancers of the liver are in the 3rd place in cancer-related deaths. Hepatocellular carcinoma (HCC) accounts for approximately 80% of primary hepatic malignancies. The Barcelona Clinic Liver Cancer (BCLC) classification divides HCC into 5 stages and allocates treatments. The aim of this study is to examine the initial treatments of HCC patients in our center and compare them with the approaches in the guidelines. The data of patients diagnosed with HCC between 2006 and 2016 were recruited retrospectively. Age, gender, etiology, Child-Pugh score, BCLC stage, model for end-stage liver disease score, alpha-fetoprotein level, tumor characteristics, type of first treatment and survival time were evaluated. There were 228 men and 33 women. The mean age was 61±10.5. Of the 130 patients 77 were found on BCLC stage C. The first treatment according to BCLC stage were sorafenib in 22, resection in 16, TACE in 15, Ytrium-90 in 14, systemic chemotherapy other than sorafenib in 14, transplantation in 11, palliative treatment in 8, and ablation in 4 patients. The median survival time was 11.9 (8.1-15.9) months. One-year survival was 32%, three-year survival was 19%, and five-year survival was 16%. The management of HCC patients was performed according to more than just BCLC guidelines in our center. The high number of patients who did not receive treatment may indicate that we need to show sufficient clinical attention to Stage D patients.

Anahtar Kelimeler

Hepatocellular Carcinoma, Survival, Treatment Protocols

Etik Beyan

Ethics committee approval (place/date/number): Akdeniz University Faculty of Medicine Ethics Committee/decision date: 01.03.2017/decision number: 140).

Hepatoselüler Kanser Tanılı Olguların Demografik, Klinik ve Tedavi Özellikleri: Tek Merkezin 10 Yıl Deneyimi

Öz

Karaciğerin primer kanserleri, kansere bağlı ölümlerde 3. sırada yer almaktadır. Hepatoselüler karsinom (HSK), primer hepatik malignitelerin yaklaşık %80’ini oluşturur. Barcelona Clinic Liver Cancer (BCLC) sınıflaması HSK’yı 5 evreye böler ve tedavileri tahsis eder. Bu çalışmanın amacı merkezimizdeki HSK hastalarının aldıkları ilk tedavilerin incelenerek kılavuzlardaki yaklaşım ile karşılaştırmaktır. Çalışmamızda, 2006-2016 yılları arasında HSK tanısı almış hastaların verileri geriye dönük irdelendi. Hastaların yaş, cinsiyet, etiyoloji, Child-Pugh skoru, BCLC evresi, model for end-stage liver disease skoru, alfa fetoprotein düzeyi, tümör özellikleri, aldıkları ilk tedavi türü ve sağ kalım süresine bakıldı ve istatistiksel analizi yapıldı. Hastaların ortalama yaşı 61±10,5; 228‘i erkek, 33‘ü kadındı. Çalışmada yer alan hastaların 130’unun BCLC evresi değerlendirilebildi. Bu hastaların 77’sinin BCLC evre C olduğu saptandı. BCLC sınıflamasına göre hastaların ilk tedavilerini değerlendirdiğimizde, 22 hastaya sorafenib, 16 hastaya rezeksiyon, 15 hastaya TAKE, 14 hastaya Yitrium-90, 14 hastaya sorafenib dışı sistemik kemoterapi, 11 hastaya transplantasyon, 8 hastaya palyatif tedavi ve 4 hastaya ablasyon uygulandığı bulundu. Sağkalım süresinin 11.9 (8,1-15,9) ay ve bir yıllık sağ kalımın %32, üç yıllık sağ kalımın %19, beş yıllık sağ kalımın %16 olduğu saptandı. Merkezimizde HCC hastalarının yönetiminde BCLC kılavuzunun yanı sıra güncel literatür ve NCCN kılavuzundan da faydalanıldığı saptandı. Tedavi almayan hasta sayısının fazla olması da Evre D hastalara yeterli klinik ilgiyi göstermemiz gerektiğinin göstergesi olabileceğini düşündürdü.

Anahtar Kelimeler

Hepatoselüler Karsinom, Sağkalım, Tedavi Protokolleri

Kaynakça

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