The role of a multidisciplinary approach in the treatment of hepatocellular carcinoma
- Authors: Kit O.I.1, Vladimirova L.I.1, Storozhakova A.E.1, Snezhko T.A.1, Kalabanova E.A.1, Samaneva N.I.1, Svetitskaia I.V.1, Kabanov S.N.1
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Affiliations:
- Rostov Research Institute of Oncology
- Issue: Vol 21, No 4 (2019)
- Pages: 10-14
- Section: CLINICAL ONCOLOGY
- URL: https://journals.rcsi.science/1815-1434/article/view/34000
- DOI: https://doi.org/10.26442/18151434.2019.4.190694
- ID: 34000
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Abstract
Aim. Evaluation of treatment options and efficacy in patients with hepatocellular carcinoma based on data from the FSBI Rostov Cancer Research Institute using a multidisciplinary approach to the problem.
Materials and methods. 124 cases of hepatocellular carcinoma were analyzed. In 79.8% of patients (average age of 61.4 years) the disease was diagnosed at advanced stages (III–IV). Antibodies to viral hepatitis B were detected in 18 (14.5%) patients, and antibodies to viral hepatitis C – in 35 (28.2%) patients. Liver cirrhosis occurred in 38 (30.6%) cases, and Child–Pugh class A – in 20 (16.1%) cases. In the FSBI RCRI, a multidisciplinary approach has been introduced into clinical practice; decision on treatment tactics is made with a close cooperation of several specialists. The use of special treatment methods was available in 67 (54%) patients. 32 patients with Barcelona Clinic Liver Cancer (BCLC) stage A (early) or stage B (intermediate), had surgical treatment or hepatic arterial chemoembolization (HACE) with lipiodol or microspheres using various cytostatics (18 and 14 patients, respectively). 35 patients with advanced stage C were given a systemic therapy with various cytostatics (gemcitabine, oxaliplatin, doxorubicin) or targeted therapy with sorafenib. The treatment efficacy was assessed according to mRECIST.
Results. The best median overall survival (OS) – up to 21 months – was in the group of patients (n=18) who underwent volume resection surgery. In this group, sorafenib was prescribed to 2 patients after surgery. When performing HACE, the median OS was 14.2 months. In 6 patients, HACE was performed 2 or more times. Among the 14 patients who had HACE, sorafenib was prescribed in 8 cases, and the median OS in this group was 16.3 months. 20 patients were given targeted therapy with sorafenib. Following 3 months of taking the drug, 16 patients achieved stabilization of the disease according to the mRECIST, in 1 patient – a partial response, in 3 patients – disease progression. Median OS was 9.1 months; progression-free survival among patients treated with sorafenib was 5.4 months.
Conclusions. The use of a multidisciplinary approach in clinical practice makes it possible to choose the optimal treatment option for hepatocellular carcinoma and contributes to the improvement in OS. The combination of local treatment methods (surgical treatment, HACE) with effective drug therapy is the most optimal approach to treating patients with advanced stages of hepatocellular carcinoma.
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##article.viewOnOriginalSite##About the authors
Oleg I. Kit
Rostov Research Institute of Oncology
Author for correspondence.
Email: vlu@aaanet.ru
ORCID iD: 0000-0003-3061-6108
Corr. Memb. RAS, D. Sci. (Med.), Prof.
Russian Federation, Rostov-on-DonLiubov Iu. Vladimirova
Rostov Research Institute of Oncology
Email: vlu@aaanet.ru
ORCID iD: 0000-0003-4236-6476
D. Sci. (Med.), Prof.
Russian Federation, Rostov-on-DonAnna E. Storozhakova
Rostov Research Institute of Oncology
Email: maymur@list.ru
ORCID iD: 0000-0003-0965-0264
Cand. Sci. (Med.)
Russian Federation, Rostov-on-DonTatiana A. Snezhko
Rostov Research Institute of Oncology
Email: tatyana_snezhko@mail.ru
ORCID iD: 0000-0002-9661-9312
Cand. Sci. (Med.)
Russian Federation, Rostov-on-DonElena A. Kalabanova
Rostov Research Institute of Oncology
Email: alenakalabanova@mail.ru
ORCID iD: 0000-0003-0158-3757
Cand. Sci. (Med.)
Russian Federation, Rostov-on-DonNatalia Iu. Samaneva
Rostov Research Institute of Oncology
Email: tenero_passione@mail.ru
ORCID iD: 0000-0003-0843-6012
Doctor
Russian Federation, Rostov-on-DonIana V. Svetitskaia
Rostov Research Institute of Oncology
Email: tenero_passione@mail.ru
ORCID iD: 0000-0001-5371-0709
Cand. Sci. (Med.)
Russian Federation, Rostov-on-DonSergei N. Kabanov
Rostov Research Institute of Oncology
Email: introitus@mail.ru
ORCID iD: 0000-0001-8628-4240
Cand. Sci. (Med.)
Russian Federation, Rostov-on-DonReferences
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