Aggressive Treatment of Performance Status 1 and 2 HCC Patients Significantly Improves Survival - an Egyptian Retrospective Cohort Study of 524 Cases

Aziz, Ashraf Omar Abdel; Omran, Dalia; Nabeel, Mohamed Mahmoud; Elbaz, Tamer Mahmoud; Abdelmaksoud, Ahmed Hosni; Attar, Inas El; Shousha, Hend Ibrahim

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저자정보: Aziz, Ashraf Omar Abdel (Department of Endemic Medicine and Hepatogastroenterology, National Cancer Institute, Cairo University) Omran, Dalia (Department of Endemic Medicine and Hepatogastroenterology, National Cancer Institute, Cairo University) Nabeel, Mohamed Mahmoud (Department of Endemic Medicine and Hepatogastroenterology, National Cancer Institute, Cairo University) Elbaz, Tamer Mahmoud (Department of Endemic Medicine and Hepatogastroenterology, National Cancer Institute, Cairo University) Abdelmaksoud, Ahmed Hosni (Department of Diagnostic and Interventional Radiology, Faculty of Medicine, National Cancer Institute, Cairo University) Attar, Inas El (Department of Biostatistics and Cancer Epidemiology, National Cancer Institute, Cairo University) Shousha, Hend Ibrahim (Department of Endemic Medicine and Hepatogastroenterology, National Cancer Institute, Cairo University)

저널정보: 아시아태평양암예방학회 Asian Pacific journal of cancer prevention : APJCP Asian Pacific journal of cancer prevention : APJCP 제17권 제5호

발행연도: 2016.1

수록면: 2,539 - 2,543 (5page)

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Background: In the Barcelona Clinic Liver Cancer (BCLC) system, only sorafenib is suggested for HCC patients having performance status (PS) 1 or 2 even if they have treatable lesions. In the current study, we aimed to explore the outcome of using aggressive treatment for HCC patients with PS 1 and 2. Materials and Methods: Five hundred and twenty four patients with HCC were enrolled in this study and divided into 2 groups: 404 PS 1 and 120 PS 2. Of the included 524 patients, 136 recceived non-aggressive supportive treatment and sorafenib, while 388 patients were offered aggressive treatment in the form of surgical resection, transplantation, percutaneous ablation, trans-arterial chemoembolization and/or chemoperfusion. All the patients were followed up for a period of 2 years to determine their survival. Results: Most HCC patients were CHILD A and B grades (89.4% versus 85.0%, for PS1 and PS2, respectively). Patients with PS1 were significantly younger. Out of the enrolled 524 patients, 388 were offered aggressive treatment, 253 (65.2%) having their lesions fully ablated, 94 (24.2%) undergoing partial ablation and 41 patients with no ablation (10.6%). The median survival of the patients with PS 1 who were offered aggressive treatment was 20 months versus 9 months only for those who were offered supportive treatment and sorafenib (p<0.001). Regarding HCC patients with PS 2, the median survivals were similarly 19.7 months versus 8.7 months only (p<0.001). Conclusions: Aggressive treatment of HCC patients with PS 1 and 2 significantly improves their survival. Revising the BCLC guidelines regarding such patients is recommended.

#HCC #performance status #aggressive treatment #outcome #prognosis

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Aziz, Ashraf Omar Abdel

소속기관 Department of Endemic Medicine and Hepatogastroenterology, National Cancer Institute, Cairo Universi