• 作者：Marí ; a Varela^a ; ^{maria.varela.calvo@gmail.com} ; Marí ; a Reig^b ; Manuel de la Mata^c ; Ana Matilla^d ; Javier Bustamante^e ; Sonia Pascual^f ; Juan Turnes^g ; Carles Aracil^h ; Adolfo del Valⁱ ; Juan Manuel Pascasio^j ; Manuel Rodrí ; guez^a ; Jordi Bruix^b
• 关键词：Carcinoma hepatocelular ; Registro nacional ; Cribado ; Tratamiento ; Clasificació ; n Barcelona Clinic Liver Cancer ; Trasplante hepá ; tico ; Quimioembolizació ; n ; Sorafenib
• 刊名：Medicina Cl铆nica
• 出版年：2010
• 期刊代码：pca254_00257753
• 类别：med
• 出版时间：8 May 2010
• 卷：134
• 期：13
• 页码：569-576
• 文件大小：236 K

Background and objective

Hepatocellular carcinoma (HCC) is the leading cause of death in patients with cirrhosis and its current situation in Spain is not well known. Therefore, a national registry was created to assess the characteristics of patients with de novo HCC.

Patients and method

Between 1/10/2008 and 31/1/2009, 62 centers reported the baseline demographic, clinical and tumor characteristics, the first choice of treatment and eligibility for transplantation (OLT) of HCC diagnosed during this time.

Results

There were 705 new cases of HCC, 78%men, mean age 65 years, 89%cirrhosis (58%Child-Pugh class A, 42%HCV, 30%alcohol). Only 334 cases (47%) were diagnosed by screening. The size of the main nodule and BCLC stage were significantly lower in the screening group than in the rest (p<0.001). The applicability of radical therapies (resection and percutaneous ablation) was significantly higher (47.5%versus 24.6%, p<0.001) as well as the evaluation for OLT (31%versus 12%, p<0.001). The screening did not differ according to gender (p=0.204) or age (<50 years, <65, <75, >75 years) (p=0.171). Chemoembolization was the most common treatment: initial tumors (46.4%), tumors >5 cm (15.7%), multifocal HCC (37.9%) and as a bridge to OLT (33%).

Conclusion

The majority of HCC patients are diagnosed in Spain out of early detection programs, and this limits the chance for early diagnosis and effective therapy.