[Treatment approach of hepatocellular carcinoma in Spain. Analysis of 705 patients from 62 centers].
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.
Varela
María
M
Servicio de Aparato Digestivo, Hospital Universitario Central de Asturias, Oviedo, España. maria.varela.calvo@gmail.com
Reig
María
M
de la Mata
Manuel
M
Matilla
Ana
A
Bustamante
Javier
J
Pascual
Sonia
S
Turnes
Juan
J
Aracil
Carles
C
Del Val
Adolfo
A
Pascasio
Juan Manuel
JM
Rodríguez
Manuel
M
Bruix
Jordi
J
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
D000970:Antineoplastic Agents; D001557:Benzenesulfonates; D010671:Phenylurea Compounds; D011725:Pyridines; D015021:Yttrium Radioisotopes; D009536:Niacinamide; D000077157:Sorafenib