Multidisciplinary decision making in the management of hepatocellular carcinoma: A hospital-based study.
OBJECTIVE
To evaluate the short-term outcome of the decision taken by the Hepatoma Board for the treatment of Hepatocellular carcinoma (HCC).


METHODS
This was a prospective descriptive study involving 74 patients with HCC diagnosed by the known criteria. The decisions taken by the Hepatoma Board for the 74 patients were as follows: 1- surgical resection (7 patients), 2- local ablative therapy (LAT) (22 patients), 3- conventional transarterial chemoembolization (TACE) (24 patients), and 4- palliative supportive care (21 patients).


RESULTS
The short-term mortality rate was 25.7% of the total patients. The success rate was nearly equal in LAT (68.2%) and surgery (71.4%), whereas the success rate was approximately 33.3% in TACE. There was no difference in the mean total bilirubin level before and after LAT, surgery, or TACE (p>0.05 for each). There was a significant decrease in the mean serum albumin level after TACE (p=0.000). There was a decrease in the mean alpha fetoprotein level after surgery and LAT (p=0.033) for surgery and (p=0.048) for LAT.


CONCLUSIONS
The management of HCC is better performed through a multidisciplinary team decision. Surgery has comparable outcome to LAT but is more invasive. According to our local experience, conventional TACE has a success rate of 33.3%.
Department of Tropical Medicine and Gastroenterology, Assiut University Faculty of Medicine, Assiut, Egypt. nahedmak@yahoo.com.
Saad
S
Zaky
Nahed A
NA
Makhlouf
Mohamed O
MO
Abdel Malek
Ahmed A
AA
Bakheet
Hany M A
HM
Seif
Hesham M
HM
Hamza
Abeer M M
AM
Sabry
D055011:Ablation Techniques / Q000401:mortality; D000328:Adult; D000368:Aged; D001663:Bilirubin / Q000097:blood; D006528:Carcinoma, Hepatocellular / Q000097:blood / Q000401:mortality / Q000628:therapy*; D016461:Chemoembolization, Therapeutic / Q000401:mortality; D000066491:Clinical Decision-Making / Q000379:methods*; D019468:Disease Management; D005260:Female; D006801:Humans; D008099:Liver / Q000601:surgery; D008113:Liver Neoplasms / Q000097:blood / Q000401:mortality / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010166:Palliative Care; D010348:Patient Care Team; D011446:Prospective Studies; D012709:Serum Albumin / Q000032:analysis; D016896:Treatment Outcome; D000509:alpha-Fetoproteins / Q000032:analysis
D012709:Serum Albumin; D000509:alpha-Fetoproteins; D001663:Bilirubin