Real-life Adherence to BCLC Therapeutic Algorithm of Hepatocellular carcinoma in a Multicenter cohort from Argentina

RIDRUEJO E

Congreso; American Association for the Study of Liver Diseases; 2016

Background & Aims: The Barcelona Clinic Liver Cancer (BCLC) algorithm has been accepted forstaging and management of hepatocellular carcinoma (HCC). However, adherence to BCLC in the daily practice is stillchallenging. We aimed to analyze adherence to BCLC recommendation and its impact on patient survival.Methods: A cohort study was conducted between 2009 and 2016 in 14 different regional hospitals from Argentinaincluding adult patients with newly diagnosed HCC. Study data was registered into a web-based electronic system.Results: Between 2009 and 2016, 720 consecutive patients were included (non-cirrhotic n=73). Hepatitis C virus wasthe main cause of liver disease (37%). Overall, 58% of the cohort was under screening. At diagnosis, BCLC stageswere as follows: stage 0 4%, A 43%, B 22%, C 9% and D 22%. Analysis of treatments performed according to BCLCrecommendation showed that 45% of the patients were first treated according to BCLC, 24% under-treated, 29% overtreatedand 2% not treated until last day of follow-up. BCLC adherence increased to 55.3% for subsequent treatments.Corresponding 5-year survival rates were as follows: stage 0 77%, stage A 74%, stage B 62%, stage C 33% andstage D 19% (Figure). Significant lower survival was observed among patients who were not screened (43% vs 70%;HR 3.27, P