Adherence to Barcelona Clinic Liver Cancer guidelines in field practice: Results of Progetto Epatocarcinoma Campania

• DOI: 10.1111/jgh.14013
• Publication Date: 2017-10-10T01:12:36Z
• Authors: Maria Guarino; Raffaella Tortora; Giorgio de Stefano; Carmine Coppola; Filomena Morisco; Angelo Salomone M...; Francesco Izzo; Gerardo Nardone; Guido Piai; Luigi Elio Adinolfi; Giuseppe D'Adamo; Giovanni Battista...; Vincenzo Messina; Giampiero Francica; Vincenzo De Girolamo; Nicola Coppola; Marcello Persico; Giovan Giuseppe D...
• Keywords: Liver Cancer; Liver function

Abstract Background and Aim The Barcelona Clinic Liver Cancer (BCLC) algorithm is the standard system for clinical management of hepatocellular carcinoma (HCC). Data on adherence to this therapeutic paradigm are scarce. This field practice study aimed provide a description HCC cirrhotic patients in Southern Italy, evaluate BCLC guidelines its impact patients' survival. Methods We analyzed region‐wide Italian database Progetto Epatocarcinoma Campania , which includes data patients, prospectively collected from January 2013 December 2015 16 regional centers. Results Overall, 1008 were enrolled: 70.6% received therapies recommended by algorithm, while 29.4% underwent different treatments. Among who treated guidelines, higher rate diagnosis surveillance programs, better liver function, lower alpha‐fetoprotein > 200 ng/mL, more early‐stage monofocal HCC, frequency nodules 5 cm, portal vein thrombosis metastases observed. overall survival was evaluated according stage no differences between groups managed differently found. multivariate analysis showed that non‐adherence treatment independently associated B, Child–Pugh classes B C, presence neoplastic metastases. Conclusion Adherence high early end‐stage but it poor intermediate advanced patients.