演題抄録

臓器別シンポジウム

開催概要
開催回
第55回・2017年・横浜
 

Factors influencing indications for treatment of hepatocellular carcinoma in Sweden

演題番号 : OSY16-1

[筆頭演者]
Peter LJ Naredi:1 
[共同演者]
Malin Sternby Eilard:2、Magnus Rizell:2

1:University of Gothenburg・Department of surgery・Institute of clinical sciences、2:University of Gothenburg・Department of transplantation surgery・Institute of clinical sciences

 

Prognosis for patients diagnosed with hepatocellular carcinoma (HCC) depend on tumour stage, overall health of the patient, hepatic function and the efficacy of treatment. In a Scandinavian study of HCC patients we evaluated quality of life by the EORTC QLQ C-30 and EORTC QLQ HCC-18. We found that quality of life assessed by EORTC QLQ C-30 and HCC-18 can be used for prognostication of patients with HCC. Fatigue and nutrition scales were the strongest predictors. In addition, the quality of life instruments could be added to BCLC and CLIP to increase the prognostic accuracy of survival outcome.

For a selection of HCC patients liver transplantation is curative. Currently the UCSF criteria are used as selection criteria in Sweden but a drawback is that they do not reflect tumour biology. Patients within the criteria do have tumour recurrences and outside the criteria some patients might have benefited from a liver transplantation. In a retrospective analyses of all patients liver transplanted for HCC in Sweden between 1996 and 2014 we studied whether alpha fetoprotein (AFP) levels in addition to traditional selection criteria could improve the selection accuracy for liver transplantation. AFP levels discriminated outcome and a combined score depending on both fulfilling traditional selection criteria, Milan and UCSF, and of AFP-levels ameliorated predictive accuracy.

Both the quality of life assessment tools and the addition of AFP to traditional selection criteria will influence the decision making and clarify indications for treatment of hepatocellular carcinoma in Sweden.

前へ戻る