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자료유형
학술저널
저자정보
저널정보
대한간학회 Clinical and Molecular Hepatology Clinical and Molecular Hepatology 제17권 제2호
발행연도
2011.1
수록면
113 - 119 (7page)

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Background/Aims:The Barcelona Clinic Liver Cancer (BCLC) staging system is logical for the staging and treatment of hepatocellular carcinoma (HCC) because it was based on survival data. This study evaluated the applicability of the BCLC staging system and reasons for divergence from BCLC-recommended treatments in Korean HCC patients. Methods:One hundred and sixty consecutive HCC patients were prospectively enrolled. Treatments were generally recommended according to the guideline of the American Association for the Study of Liver Diseases, but patients were also informed about alternative treatments. The final decision was made with patient agreement, and was based on the doctor’s preferences when a patient was unable to reach a decision. Results:There were 2 (1%), 101 (64%), 20 (12.5%), 34 (21.5%), and 3 (1%) patients with very early-, early-, intermediate-, advanced-, and terminal-stage disease, respectively. Only 64 patients (40%) were treated according to BCLC recommendations. The treatment deviated from BCLC recommendations in 68% (69/101) and 79% (27/34) of patients with early and advanced stage, respectively. The main causes of deviation were refusal to undergo surgery, the presence of an indeterminate malignancy nodule, the absence of a suitable donor, or financial problems. Conclusions:Donor shortage, financial problems, the relatively limited efficacy of molecular targeting agents, and the presence of an indeterminate nodule were the main causes of deviation from BCLC recommendations. Even after excluding cases in which decisions were made by patient preference, only 66% of the HCC patients were treated according to BCLC recommendations. Treatment guidelines that reflect the Korean situation are mandatory for HCC patients.
#Hepatocellular carcinoma #Barcelona Clinic Liver Cancer #BCLC) #Neoplasm staging #Treatment #Korea

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참고문헌 (19)

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Cheng AL / 2009 / Efficacy and safety of sorafenib in patients in the Asia-Pacific region with advanced hepatocellular carcinoma: a phase III randomised, double-blind, place google schola Chevret S / 1999 / A new prognostic classification for predicting survival in patients with hepatocellular carcinoma. Groupe d'Etude et de Traitement du Carcinome Hepatocellu google schola Chung JW / 1995 / Hepatocellular carcinoma and portal vein invasion: results of treatment with transcatheter oily chemoembolization / AJR Am J Roentgenol 165 : 315 ~ 321 google schola Cillo U / 2006 / Prospective validation of the Barcelona Clinic Liver Cancer staging system / J Hepatol 44 : 723 ~ 731 google schola Forner A / 2010 / Current strategy for staging and treatment: the BCLC update and future prospects / Semin Liver Dis 30 : 61 ~ 74 google schola

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