Treatment of hepatocellular carcinoma in Child-Pugh B patients

详细信息    查看全文

• 作者：Fabio Piscaglia ; Eleonora Terzi ; Aless ; ro Cucchetti ; Chiara Trimarchi ; Aless ; ro Granito ; Simona Leoni ; Sara Marinelli ; Patrizia Pini ; Luigi Bolondi
• 关键词：Hepatocellular carcinoma ; Liver function ; Transarterial chemoembolisation ; Tumour staging systems
• 刊名：Digestive and Liver Disease
• 出版年：2013
• 出版时间：October, 2013
• 年：2013
• 卷：45
• 期：10
• 页码：852-858
• 全文大小：403 K

文摘

Background

The frequency with which patients in Child-Pugh B having hepatocellular carcinoma are treated following the international guidelines according to the Barcelona Clinic Liver Cancer stages is unknown.

Aims

To investigate treatment allocation for Child-Pugh B patients in different tumour stages, with particular interest in the intermediate stage.

Methods

Patients were retrospectively identified from a consecutively collected series. Treatment was carried out primarily according to the guidelines.

Results

Of 86 Child-Pugh B patients, 45 were Barcelona early stage, of which the Child-Pugh scores were 46.7 % B7, 33.3 % B8, 20.0 % B9; 27 patients were intermediate stage (B7 59.3 % , B8 37.0 % and B9 3.7 % respectively), 12 were advanced (41.7 % B7, 25.0 % B8 and 33.3 % B9) and 2 were terminal (both B9). In the intermediate stage, transarterial chemoembolization (or ablation) was performed in 68.8 % of the Child-Pugh B7 patients, 50 % of the B8 patients and 0 % of the B9 patients. Median survival of the intermediate patients was 8.0 months (9.0 in B7 vs. 6.0 in -B8/B9, P = 0.048). Survival of the intermediate stage patients undergoing chemoembolisation was 22.0 months in Child-Pugh B7 and 6.0 in B8.

Conclusions

Approximately half of the intermediate stage patients can undergo locoregional treatment with good survival when in the Child-Pugh B7. The Child-Pugh numeric score impacts survival, suggesting that this tumour stage be refined.