Araştırma Makalesi
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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
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.

Etik Beyan

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

Kaynakça

  • 1. Sung H, Ferlay J, Siegel RL, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2021;71(3):209-49.
  • 2. Siegel RL, Miller KD, Wagle NS, et al. Cancer statistics, 2023. CA Cancer J Clin. 2023;73(1):17-48.
  • 3. Thomas London W, Petrick JL, McGlynn KA. Liver cancer. In: M Thun, MS Linet, JR Cerhan, CA Haiman, D Schottenfeld, eds. Cancer Epidemiology and Prevention. 4th ed. Oxford University Press, pp 635-660, 2018.
  • 4. Llovet JM, Brú C, Bruix J. Prognosis of hepatocellular carcinoma: the BCLC staging classification. Semin Liver Dis. 1999;19(3):329-38.
  • 5. Forner A, Reig ME, de Lope CR, et al. Current strategy for staging and treatment: the BCLC update and future prospects. Semin Liver Dis. 2010;30(1):61-74.
  • 6. Reig M, Forner A, Rimola J, et al. BCLC strategy for prognosis prediction and treatment recommendation: The 2022 update. J Hepatol. 2022;76(3):681-93.
  • 7. Bruix J, Sherman M, Llovet JM, et al. Clinical management of hepatocellular carcinoma. Conclusions of the Barcelona-2000 EASL conference. European Association for the study of the liver. J Hepatol. 2001;35(3):421-30.
  • 8. European Association for Study of Liver, European Organisation for Research and Treatment of Cancer. EASL-EORTC clinical practice guidelines: management of hepatocellular carcinoma. Eur J Cancer. 2012;48(5):599-641.
  • 9. European Association for the Study of the Liver. EASL Clinical Practice Guidelines: Management of hepatocellular carcinoma. J Hepatol. 2018;69(1):182-236.
  • 10. Benson AB 3rd, D'Angelica MI, Abbott DE, et al. NCCN Guidelines Insights: Hepatobiliary Cancers, Version 1.2017. J Natl Compr Canc Netw. 2017;15(5):563-73.
  • 11. Xia F, Wu LL, Lau WY, et al. Adjuvant sorafenib after heptectomy for Barcelona Clinic Liver Cancer-stage C hepatocellular carcinoma patients. World J Gastroenterol. 2016;22(23):5384-92.
  • 12. Chen J, Xi W, Wu B, et al. Clinical observation of transcatheter arterial chemoembolization plus sorafenib in the treatment of hepatocellular carcinoma with portal vein tumor thrombosis. Zhonghua Yi Xue Za Zhi. 2014;94(33):2566-9.
  • 13. Bruix J, Sherman M; American Association for the Study of Liver Diseases. Management of hepatocellular carcinoma: an update. Hepatology. 2011;53(3):1020-2.
  • 14. Davila JA, Morgan RO, Richardson PA, et al. Use of surveillance for hepatocellular carcinoma among patients with cirrhosis in the United States. Hepatology. 2010;52(1):132-41.
  • 15. Singal AG, Yopp AC, Gupta S, et al. Failure rates in the hepatocellular carcinoma surveillance process. Cancer Prev Res (Phila). 2012;5(9):1124-30.
  • 16. Alacacioglu A, Somali I, Simsek I, et al. Epidemiology and survival of hepatocellular carcinoma in Turkey: outcome of multicenter study. Jpn J Clin Oncol. 2008;38(10):683-8.
  • 17. Stacy S, Hyder O, Cosgrove D, et al. Patterns of consultation and treatment of patients with hepatocellular carcinoma presenting to a large academic medical center in the US. J Gastrointest Surg. 2013;17(9):1600-8.
  • 18. Ikai I, Kudo M, Arii S, et al. Report of the 18th follow-up survey of primary liver cancer in Japan. Hepatol Res. 2010;40(11):1043-59.
  • 19. Saito H, Masuda T, Tada S, et al. Hepatocellular carcinoma in Keio affiliated hospitals--diagnosis, treatment, and prognosis of this disease. Keio J Med. 2009;58(3):161-75.
  • 20. Chapter 6: Cancer Survival. Ontario Cancer Statistics 2022. Accession date 23.08.2023, https://www.cancercareontario.ca/en/data-research/view-data/statistical-reports/ontario-cancer-statistics-2022/ch-6-cancer-survival-2022.
  • 21. Bosetti C, Turati F, La Vecchia C. Hepatocellular carcinoma epidemiology. Best Pract Res Clin Gastroenterol. 2014;28(5):753-70.

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

Yıl 2023, Cilt: 10 Sayı: 3, 186 - 190, 19.12.2023
https://doi.org/10.47572/muskutd.1352879

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.

Kaynakça

  • 1. Sung H, Ferlay J, Siegel RL, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2021;71(3):209-49.
  • 2. Siegel RL, Miller KD, Wagle NS, et al. Cancer statistics, 2023. CA Cancer J Clin. 2023;73(1):17-48.
  • 3. Thomas London W, Petrick JL, McGlynn KA. Liver cancer. In: M Thun, MS Linet, JR Cerhan, CA Haiman, D Schottenfeld, eds. Cancer Epidemiology and Prevention. 4th ed. Oxford University Press, pp 635-660, 2018.
  • 4. Llovet JM, Brú C, Bruix J. Prognosis of hepatocellular carcinoma: the BCLC staging classification. Semin Liver Dis. 1999;19(3):329-38.
  • 5. Forner A, Reig ME, de Lope CR, et al. Current strategy for staging and treatment: the BCLC update and future prospects. Semin Liver Dis. 2010;30(1):61-74.
  • 6. Reig M, Forner A, Rimola J, et al. BCLC strategy for prognosis prediction and treatment recommendation: The 2022 update. J Hepatol. 2022;76(3):681-93.
  • 7. Bruix J, Sherman M, Llovet JM, et al. Clinical management of hepatocellular carcinoma. Conclusions of the Barcelona-2000 EASL conference. European Association for the study of the liver. J Hepatol. 2001;35(3):421-30.
  • 8. European Association for Study of Liver, European Organisation for Research and Treatment of Cancer. EASL-EORTC clinical practice guidelines: management of hepatocellular carcinoma. Eur J Cancer. 2012;48(5):599-641.
  • 9. European Association for the Study of the Liver. EASL Clinical Practice Guidelines: Management of hepatocellular carcinoma. J Hepatol. 2018;69(1):182-236.
  • 10. Benson AB 3rd, D'Angelica MI, Abbott DE, et al. NCCN Guidelines Insights: Hepatobiliary Cancers, Version 1.2017. J Natl Compr Canc Netw. 2017;15(5):563-73.
  • 11. Xia F, Wu LL, Lau WY, et al. Adjuvant sorafenib after heptectomy for Barcelona Clinic Liver Cancer-stage C hepatocellular carcinoma patients. World J Gastroenterol. 2016;22(23):5384-92.
  • 12. Chen J, Xi W, Wu B, et al. Clinical observation of transcatheter arterial chemoembolization plus sorafenib in the treatment of hepatocellular carcinoma with portal vein tumor thrombosis. Zhonghua Yi Xue Za Zhi. 2014;94(33):2566-9.
  • 13. Bruix J, Sherman M; American Association for the Study of Liver Diseases. Management of hepatocellular carcinoma: an update. Hepatology. 2011;53(3):1020-2.
  • 14. Davila JA, Morgan RO, Richardson PA, et al. Use of surveillance for hepatocellular carcinoma among patients with cirrhosis in the United States. Hepatology. 2010;52(1):132-41.
  • 15. Singal AG, Yopp AC, Gupta S, et al. Failure rates in the hepatocellular carcinoma surveillance process. Cancer Prev Res (Phila). 2012;5(9):1124-30.
  • 16. Alacacioglu A, Somali I, Simsek I, et al. Epidemiology and survival of hepatocellular carcinoma in Turkey: outcome of multicenter study. Jpn J Clin Oncol. 2008;38(10):683-8.
  • 17. Stacy S, Hyder O, Cosgrove D, et al. Patterns of consultation and treatment of patients with hepatocellular carcinoma presenting to a large academic medical center in the US. J Gastrointest Surg. 2013;17(9):1600-8.
  • 18. Ikai I, Kudo M, Arii S, et al. Report of the 18th follow-up survey of primary liver cancer in Japan. Hepatol Res. 2010;40(11):1043-59.
  • 19. Saito H, Masuda T, Tada S, et al. Hepatocellular carcinoma in Keio affiliated hospitals--diagnosis, treatment, and prognosis of this disease. Keio J Med. 2009;58(3):161-75.
  • 20. Chapter 6: Cancer Survival. Ontario Cancer Statistics 2022. Accession date 23.08.2023, https://www.cancercareontario.ca/en/data-research/view-data/statistical-reports/ontario-cancer-statistics-2022/ch-6-cancer-survival-2022.
  • 21. Bosetti C, Turati F, La Vecchia C. Hepatocellular carcinoma epidemiology. Best Pract Res Clin Gastroenterol. 2014;28(5):753-70.
Toplam 21 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular İç Hastalıkları, Klinik Tıp Bilimleri (Diğer)
Bölüm Araştırma Makalesi
Yazarlar

Ezgi Avanaz 0009-0002-7974-4514

Dinç Dinçer 0000-0001-6769-9344

Ali Avanaz 0000-0002-4559-4258

Gülsüm Özlem Elpek 0000-0002-1237-5454

Esra Çobankent Aytekin 0000-0002-0500-7987

Erdem Ayık 0000-0002-1850-9812

Yayımlanma Tarihi 19 Aralık 2023
Gönderilme Tarihi 31 Ağustos 2023
Yayımlandığı Sayı Yıl 2023 Cilt: 10 Sayı: 3

Kaynak Göster

APA Avanaz, E., Dinçer, D., Avanaz, A., Elpek, G. Ö., vd. (2023). Demographic, Clinical and Treatment Characteristics of Patients with Hepatocellular Cancer: 10 Years of Experience of a Single Center. Muğla Sıtkı Koçman Üniversitesi Tıp Dergisi, 10(3), 186-190. https://doi.org/10.47572/muskutd.1352879
AMA Avanaz E, Dinçer D, Avanaz A, Elpek GÖ, Çobankent Aytekin E, Ayık E. Demographic, Clinical and Treatment Characteristics of Patients with Hepatocellular Cancer: 10 Years of Experience of a Single Center. MMJ. Aralık 2023;10(3):186-190. doi:10.47572/muskutd.1352879
Chicago Avanaz, Ezgi, Dinç Dinçer, Ali Avanaz, Gülsüm Özlem Elpek, Esra Çobankent Aytekin, ve Erdem Ayık. “Demographic, Clinical and Treatment Characteristics of Patients With Hepatocellular Cancer: 10 Years of Experience of a Single Center”. Muğla Sıtkı Koçman Üniversitesi Tıp Dergisi 10, sy. 3 (Aralık 2023): 186-90. https://doi.org/10.47572/muskutd.1352879.
EndNote Avanaz E, Dinçer D, Avanaz A, Elpek GÖ, Çobankent Aytekin E, Ayık E (01 Aralık 2023) Demographic, Clinical and Treatment Characteristics of Patients with Hepatocellular Cancer: 10 Years of Experience of a Single Center. Muğla Sıtkı Koçman Üniversitesi Tıp Dergisi 10 3 186–190.
IEEE E. Avanaz, D. Dinçer, A. Avanaz, G. Ö. Elpek, E. Çobankent Aytekin, ve E. Ayık, “Demographic, Clinical and Treatment Characteristics of Patients with Hepatocellular Cancer: 10 Years of Experience of a Single Center”, MMJ, c. 10, sy. 3, ss. 186–190, 2023, doi: 10.47572/muskutd.1352879.
ISNAD Avanaz, Ezgi vd. “Demographic, Clinical and Treatment Characteristics of Patients With Hepatocellular Cancer: 10 Years of Experience of a Single Center”. Muğla Sıtkı Koçman Üniversitesi Tıp Dergisi 10/3 (Aralık 2023), 186-190. https://doi.org/10.47572/muskutd.1352879.
JAMA Avanaz E, Dinçer D, Avanaz A, Elpek GÖ, Çobankent Aytekin E, Ayık E. Demographic, Clinical and Treatment Characteristics of Patients with Hepatocellular Cancer: 10 Years of Experience of a Single Center. MMJ. 2023;10:186–190.
MLA Avanaz, Ezgi vd. “Demographic, Clinical and Treatment Characteristics of Patients With Hepatocellular Cancer: 10 Years of Experience of a Single Center”. Muğla Sıtkı Koçman Üniversitesi Tıp Dergisi, c. 10, sy. 3, 2023, ss. 186-90, doi:10.47572/muskutd.1352879.
Vancouver Avanaz E, Dinçer D, Avanaz A, Elpek GÖ, Çobankent Aytekin E, Ayık E. Demographic, Clinical and Treatment Characteristics of Patients with Hepatocellular Cancer: 10 Years of Experience of a Single Center. MMJ. 2023;10(3):186-90.