title: [Treatment approach of hepatocellular carcinoma in Spain. Analysis of 705 patients from 62 centers].
abstract: 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.
  
  
  METHODS
  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%).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Servicio de Aparato Digestivo, Hospital Universitario Central de Asturias, Oviedo, España. maria.varela.calvo@gmail.com
authors.forename: María
authors.initials: M
authors.lastname: Varela
authors.forename: María
authors.initials: M
authors.lastname: Reig
authors.forename: Manuel
authors.initials: M
authors.lastname: de la Mata
authors.forename: Ana
authors.initials: A
authors.lastname: Matilla
authors.forename: Javier
authors.initials: J
authors.lastname: Bustamante
authors.forename: Sonia
authors.initials: S
authors.lastname: Pascual
authors.forename: Juan
authors.initials: J
authors.lastname: Turnes
authors.forename: Carles
authors.initials: C
authors.lastname: Aracil
authors.forename: Adolfo
authors.initials: A
authors.lastname: Del Val
authors.forename: Juan Manuel
authors.initials: JM
authors.lastname: Pascasio
authors.forename: Manuel
authors.initials: M
authors.lastname: Rodríguez
authors.forename: Jordi
authors.initials: J
authors.lastname: Bruix
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use; D001557:Benzenesulfonates / Q000627:therapeutic use; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy*; D015897:Comorbidity; D042241:Early Diagnosis; D004621:Embolization, Therapeutic / Q000706:statistics & numerical data*; D005260:Female; D006432:Hemochromatosis / Q000453:epidemiology; D006498:Hepatectomy / Q000706:statistics & numerical data*; D006525:Hepatitis, Viral, Human / Q000453:epidemiology; D006801:Humans; D008103:Liver Cirrhosis / Q000453:epidemiology; D008113:Liver Neoplasms / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy*; D008297:Male; D008403:Mass Screening; D009536:Niacinamide / Q000031:analogs & derivatives; D009765:Obesity / Q000453:epidemiology; D010671:Phenylurea Compounds; D011446:Prospective Studies; D011725:Pyridines / Q000627:therapeutic use; D012042:Registries; D012189:Retrospective Studies; D000077157:Sorafenib; D013030:Spain / Q000453:epidemiology; D016896:Treatment Outcome; D055815:Young Adult; D015021:Yttrium Radioisotopes / Q000627:therapeutic use
chemical_list: D000970:Antineoplastic Agents; D001557:Benzenesulfonates; D010671:Phenylurea Compounds; D011725:Pyridines; D015021:Yttrium Radioisotopes; D009536:Niacinamide; D000077157:Sorafenib