Abstract

Purpose. To evaluate differences in overall survival in patients with hepatocellular carcinoma (HCC) after the establishment of a multidisciplinary clinic (MDC) for HCC. Methods. Patient demographic and tumor characteristics of 355 patients diagnosed with HCC were collected between October 2006 and September 2011. Patients diagnosed after the initiation of the HCC MDC on October 1, 2010, were compared to patients diagnosed in the 4 years before. Patient demographics, tumor characteristics, treatment regimens, and overall survival were analyzed between the groups. Results. A total of 105 patients were diagnosed in the time period after HCC MDC initiation compared to 250 patients in the previous 4 years. Patients diagnosed with HCC after the HCC MDC had fewer symptoms at presentation (64 vs. 78 %, p = 0.01) and earlier stage of tumor presentation [Barcelona Clinic for Liver Cancer (BCLC) A stage, 44 vs. 26 %, p = 0.0003; tumor, node, metastasis classification system stage 1, 44 vs. 30 %, p = 0.003) compared with patients diagnosed before MDC formation. The median time to treatment after diagnosis in the later period was significantly shorter than in the earlier time period (2.3 vs. 5.3 months, p = 0.002). On multivariate analysis, being seen in the HCC MDC remained independently associated with better overall survival (hazard ratio 2.5, 95 % confidence interval 2-3), after adjusting for BCLC stage and recipient of curative treatment. Patients diagnosed after HCC MDC initiation had a median survival of 13.2 months compared to the 4.8 months observed in patients diagnosed before MDC formation (p = 0.005). Conclusions. The implementation of a MDC for the evaluation and treatment of patients with HCC is associated with improved overall survival.

Original languageEnglish (US)
Pages (from-to)1287-1295
Number of pages9
JournalAnnals of Surgical Oncology
Volume21
Issue number4
DOIs
StatePublished - 2014

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Hepatocellular Carcinoma
Survival
Liver Neoplasms
Neoplasms
Demography
Delayed Diagnosis
Therapeutics
Multivariate Analysis
Confidence Intervals
Neoplasm Metastasis

ASJC Scopus subject areas

  • Oncology
  • Surgery

Cite this

@article{5e2323d75e504f3c8a0ab223dd6a50f1,
title = "Establishment of a multidisciplinary hepatocellular carcinoma clinic is associated with improved clinical outcome",
abstract = "Purpose. To evaluate differences in overall survival in patients with hepatocellular carcinoma (HCC) after the establishment of a multidisciplinary clinic (MDC) for HCC. Methods. Patient demographic and tumor characteristics of 355 patients diagnosed with HCC were collected between October 2006 and September 2011. Patients diagnosed after the initiation of the HCC MDC on October 1, 2010, were compared to patients diagnosed in the 4 years before. Patient demographics, tumor characteristics, treatment regimens, and overall survival were analyzed between the groups. Results. A total of 105 patients were diagnosed in the time period after HCC MDC initiation compared to 250 patients in the previous 4 years. Patients diagnosed with HCC after the HCC MDC had fewer symptoms at presentation (64 vs. 78 {\%}, p = 0.01) and earlier stage of tumor presentation [Barcelona Clinic for Liver Cancer (BCLC) A stage, 44 vs. 26 {\%}, p = 0.0003; tumor, node, metastasis classification system stage 1, 44 vs. 30 {\%}, p = 0.003) compared with patients diagnosed before MDC formation. The median time to treatment after diagnosis in the later period was significantly shorter than in the earlier time period (2.3 vs. 5.3 months, p = 0.002). On multivariate analysis, being seen in the HCC MDC remained independently associated with better overall survival (hazard ratio 2.5, 95 {\%} confidence interval 2-3), after adjusting for BCLC stage and recipient of curative treatment. Patients diagnosed after HCC MDC initiation had a median survival of 13.2 months compared to the 4.8 months observed in patients diagnosed before MDC formation (p = 0.005). Conclusions. The implementation of a MDC for the evaluation and treatment of patients with HCC is associated with improved overall survival.",
author = "Yopp, {Adam C.} and Mansour, {John C.} and Beg, {Muhammad S.} and Juan Arenas and Clayton Trimmer and Mark Reddick and Ivan Pedrosa and Gaurav Khatri and Takeshi Yakoo and Meyer, {Jeffrey J.} and Jacqueline Shaw and Marrero, {Jorge A.} and Singal, {Amit G.}",
year = "2014",
doi = "10.1245/s10434-013-3413-8",
language = "English (US)",
volume = "21",
pages = "1287--1295",
journal = "Annals of Surgical Oncology",
issn = "1068-9265",
publisher = "Springer New York",
number = "4",

}

TY - JOUR

T1 - Establishment of a multidisciplinary hepatocellular carcinoma clinic is associated with improved clinical outcome

AU - Yopp, Adam C.

AU - Mansour, John C.

AU - Beg, Muhammad S.

AU - Arenas, Juan

AU - Trimmer, Clayton

AU - Reddick, Mark

AU - Pedrosa, Ivan

AU - Khatri, Gaurav

AU - Yakoo, Takeshi

AU - Meyer, Jeffrey J.

AU - Shaw, Jacqueline

AU - Marrero, Jorge A.

AU - Singal, Amit G.

PY - 2014

Y1 - 2014

N2 - Purpose. To evaluate differences in overall survival in patients with hepatocellular carcinoma (HCC) after the establishment of a multidisciplinary clinic (MDC) for HCC. Methods. Patient demographic and tumor characteristics of 355 patients diagnosed with HCC were collected between October 2006 and September 2011. Patients diagnosed after the initiation of the HCC MDC on October 1, 2010, were compared to patients diagnosed in the 4 years before. Patient demographics, tumor characteristics, treatment regimens, and overall survival were analyzed between the groups. Results. A total of 105 patients were diagnosed in the time period after HCC MDC initiation compared to 250 patients in the previous 4 years. Patients diagnosed with HCC after the HCC MDC had fewer symptoms at presentation (64 vs. 78 %, p = 0.01) and earlier stage of tumor presentation [Barcelona Clinic for Liver Cancer (BCLC) A stage, 44 vs. 26 %, p = 0.0003; tumor, node, metastasis classification system stage 1, 44 vs. 30 %, p = 0.003) compared with patients diagnosed before MDC formation. The median time to treatment after diagnosis in the later period was significantly shorter than in the earlier time period (2.3 vs. 5.3 months, p = 0.002). On multivariate analysis, being seen in the HCC MDC remained independently associated with better overall survival (hazard ratio 2.5, 95 % confidence interval 2-3), after adjusting for BCLC stage and recipient of curative treatment. Patients diagnosed after HCC MDC initiation had a median survival of 13.2 months compared to the 4.8 months observed in patients diagnosed before MDC formation (p = 0.005). Conclusions. The implementation of a MDC for the evaluation and treatment of patients with HCC is associated with improved overall survival.

AB - Purpose. To evaluate differences in overall survival in patients with hepatocellular carcinoma (HCC) after the establishment of a multidisciplinary clinic (MDC) for HCC. Methods. Patient demographic and tumor characteristics of 355 patients diagnosed with HCC were collected between October 2006 and September 2011. Patients diagnosed after the initiation of the HCC MDC on October 1, 2010, were compared to patients diagnosed in the 4 years before. Patient demographics, tumor characteristics, treatment regimens, and overall survival were analyzed between the groups. Results. A total of 105 patients were diagnosed in the time period after HCC MDC initiation compared to 250 patients in the previous 4 years. Patients diagnosed with HCC after the HCC MDC had fewer symptoms at presentation (64 vs. 78 %, p = 0.01) and earlier stage of tumor presentation [Barcelona Clinic for Liver Cancer (BCLC) A stage, 44 vs. 26 %, p = 0.0003; tumor, node, metastasis classification system stage 1, 44 vs. 30 %, p = 0.003) compared with patients diagnosed before MDC formation. The median time to treatment after diagnosis in the later period was significantly shorter than in the earlier time period (2.3 vs. 5.3 months, p = 0.002). On multivariate analysis, being seen in the HCC MDC remained independently associated with better overall survival (hazard ratio 2.5, 95 % confidence interval 2-3), after adjusting for BCLC stage and recipient of curative treatment. Patients diagnosed after HCC MDC initiation had a median survival of 13.2 months compared to the 4.8 months observed in patients diagnosed before MDC formation (p = 0.005). Conclusions. The implementation of a MDC for the evaluation and treatment of patients with HCC is associated with improved overall survival.

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U2 - 10.1245/s10434-013-3413-8

DO - 10.1245/s10434-013-3413-8

M3 - Article

C2 - 24318095

AN - SCOPUS:84896098473

VL - 21

SP - 1287

EP - 1295

JO - Annals of Surgical Oncology

JF - Annals of Surgical Oncology

SN - 1068-9265

IS - 4

ER -