HCC: multidisciplinary approach tied to better 5-year survival

  • Sinn DH & al.
  • PLoS One
  • 1 Jan 2019

  • curated by Jim Kling
  • Univadis Clinical Summaries
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Takeaway

  • Patients with hepatocellular carcinoma (HCC) who received multidisciplinary care had improved 5-year survival rates, particularly those with poor liver function, intermediate or advanced tumor stage, or high alphafetoprotein (AFP) levels.
  • The multidisciplinary team (MDT) met once a week and included hepatologists, surgeons, diagnostic radiologists, interventional radiologists, radiation oncologists, medical oncologists, pathologists, and coordinators. Each team discussed a maximum of 15 cases in 1 hour.

Why this matters

  • A multidisciplinary approach is recommended for HCC, but there is limited evidence that it improves outcome.

Study design

  • Retrospective analysis of 6619 cases and an exactly matched cohort (n=1396).
  • Funding: None.

Key results

  • 738 patients (11.1%) were managed through MDT.
  • Patients who received MDT were older, were more likely to be men, had more preserved liver function, and had less advanced tumor stage.
  • 5-year OS was higher in MDT: 71.2% vs 49.4% (P<.001>
  • In the exactly matched cohort, 5-year OS was higher in the MDT group: 71.7% vs 58.9% (P<.001>
  • MDT effect was greater for baseline albumin-bilirubin grade 2 (HR, 0.56) or 3 (HR, 0.16), BCLC stage B (HR, 0.40) or C (HR, 0.38), and serum AFP levels ≥200 ng/mL (HR, 0.50).

Limitations

  • Retrospective.
  • Single center.
  • Korean population.

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