The adherence to the American Association for the Study of Liver Diseases 2018 guidelines in the management of hepatocellular carcinoma and its impact on survival,Journal of Cancer Research and Therapeutics

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The adherence to the American Association for the Study of Liver Diseases 2018 guidelines in the management of hepatocellular carcinoma and its impact on survival
Journal of Cancer Research and Therapeutics ( IF 1.3 ) Pub Date : 2023-04-21 , DOI: 10.4103/jcrt.jcrt_1861_20
Ashish Manne ₁ , Madhuri Mulekar ₂ , Daisy Escobar ₃ , Pranitha Prodduturvar ₄ , Yazan Fahmawi ₃ , Phillip Henderson ₅ , Osama Abdul-Rahim ₆ , Zeiad Hussain ₆ , Spencer Liles ₇ , Annabelle Fonseca ₇ , John Harrison Howard ₇ , Wadad Mneimneh ₈ , Robert Gilbert ₉ , Omar Alkharabsheh ₁₀ , Sachin Pai ₁₀ , Zachary B White ₁₁ , Cindy Nelson ₁₀ , Moh'd Khushman ₁₀

Affiliation

Department of Medical Oncology, The James Comprehensive Cancer Center, Ohio State University, Columbus, OH, USA.
Departments of Mathematics and Statistics, The University of South Alabama, Mobile, AL, USA.
Department of Internal Medicine, The University of South Alabama, Mobile, AL, USA.
Department of Medical Oncology, Mayoclinic, Rochester, MN, USA.
Gastroenterology, The University of South Alabama, Mobile, AL, USA.
Interventional Radiology, The University of South Alabama, Mobile, AL, USA.
Surgical Oncology, The University of South Alabama, Mobile, AL, USA.
Pathology, Case Western Reserve University, Cleveland, OH, USA.
Radiation Oncology, The University of South Alabama, Mitchell Cancer Institute, Mobile, AL, USA.
Medical Oncology, The University of South Alabama, Mitchell Cancer Institute, Mobile, AL, USA.
College of Medicine, The University of South Alabama, Mobile, AL, USA.

Introduction:

In two Korean and Italian studies, the adherence rate (AR) to ASSLD 2005 guidelines in the management of hepatocellular carcinoma (HCC) was 60%. In a US study, the AR to American Association for the Study of Liver Disease (AASLD) 2005 guidelines was 73.3%, 26.8%, 25.3%, and 58.8% for patients with Barcelona Clinic Liver Cancer (BCLC) Stage A, B, C, and D, respectively, and nonadherence to guidelines was associated with longer overall survival (OS) in patients with BCLC Stage D. Here, we explored the AR to AASLD 2018 guidelines and its impact on OS.

Methods:

Between 2017 and 2019, 148 unique treatment-naïve patients with HCC were identified. Patients were staged according to the BCLC staging system and their AR to AASLD 2018 guidelines was noted. OS was estimated using Kaplan–Meier method. Survivals among patients from different groups was compared using Log-rank test.

Results:

The overall AR to AASLD 2018 guidelines was 83%. The AR for BCLC Stages 0, A, B, C, and D were 100%, 97%, 77%, 77%, and 38%, respectively. In patients with BCLC Stage D, the OS of patients treated with modalities adherent versus nonadherent to AASLD 2018 guidelines was 0.03 vs. 5.2 months (P = 0.0005). Otherwise, adherence versus nonadherence to AASLD 2018 guidelines showed no statistically significant differences in OS for patients with BCLC Stages 0, A, B, and C.

Conclusion:

The overall AR to AASLD 2018 guidelines was 83%. Nonadherence to AASLD 2018 guidelines in patients with BCLC Stage D translated into better OS.

中文翻译：

遵守美国肝病研究协会 2018 年肝细胞癌治疗指南及其对生存的影响

介绍：

在韩国和意大利的两项研究中，肝细胞癌 (HCC) 治疗中 ASSLD 2005 指南的遵守率 (AR) 为 60%。在美国的一项研究中，对于巴塞罗那临床肝癌 (BCLC) A、B、C 期患者，美国肝病研究协会 (AASLD) 2005 年指南的 AR 分别为 73.3%、26.8%、25.3% 和 58.8% 、和 D ，并且不遵守指南与 BCLC D 期患者较长的总生存期 (OS) 相关。在这里，我们探讨了 AASLD 2018 指南的 AR 及其对 OS 的影响。

方法：

2017 年至 2019 年间，确定了 148 名未经治疗的 HCC 患者。根据 BCLC 分期系统对患者进行分期，并记录了他们的 AR 到 AASLD 2018 指南。使用 Kaplan-Meier 方法估计 OS。使用对数秩检验比较不同组患者的生存率。

结果：

AASLD 2018 指南的总体 AR 率为 83%。BCLC 0、A、B、C 和 D 期的 AR 分别为 100%、97%、77%、77% 和 38%。在 BCLC D 期患者中，遵守 AASLD 2018 指南的治疗方式与不遵守 AASLD 2018 指南的患者的 OS 分别为 0.03 个月和 5.2 个月 ( P = 0.0005)。除此之外，遵守与不遵守 AASLD 2018 指南的结果显示，BCLC 0、A、B 和 C 期患者的 OS 没有统计学上的显着差异。