The Improvement in 1-Year Survival Rate of Patients with Hepatocellular Carcinoma BCLC Stage A and B after the Implementation of Comprehensive Management

Abstract

Background

The previous study showed lack of improvement in survival rate of hepatocellular carcinoma (HCC) patients in 2013–2014 period compared to 1998–1999 period in Indonesia due to late diagnosis. Comprehensive management of HCC has been implemented since 2015 in Cipto Mangunkusumo National General Hospital. This aims to provide better screening and surveillance in HCC patients and prioritizing of more proactive approach, such as online patient’s group discussion and social media education.

Aim

To compare the survival rates in HCC BCLC stage A and B before and after the implementation of comprehensive management.

Methods

A retrospective study design was conducted in this study. We compared the database of HCC BCLC A and B patients between the 2015–2017 period and the 2013–2014 period. Clinical parameters, modality of treatment, and 1-year survival rate were analyzed.

Results

A total of 50 patients from 2013 to 2014 period and 143 patients from 2015 to 2017 period were included in this study. After the implementation of comprehensive management, the number of patients detected in BCLC class A increased significantly (p = 0.003). In 2015–2017 period, the number of patients that received curative treatment increased significantly (p = 0.018). The 1-year survival rate of the 2015–2017 group and the 2013–2014 group was 73.9% and 47.9%, respectively, with p value 0.002.

Conclusions

The 1-year survival rate of BCLC A and BCLC B HCC patients in Cipto Mangunkusumo National Hospital improved significantly after the implementation of comprehensive management of HCC in 2015.

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Fig. 1

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Acknowledgments

We would like to thank Ms. Gita Aprilicia for her support in this study.

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Correspondence to Juferdy Kurniawan.

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The study protocol has been approved by the Ethics Committee of the Faculty of Medicine Universitas Indonesia on human research with number protocol 18-01-0018.

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The authors declare that they have no conflict of interest.

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Kurniawan, J., Gani, R.A., Hasan, I. et al. The Improvement in 1-Year Survival Rate of Patients with Hepatocellular Carcinoma BCLC Stage A and B after the Implementation of Comprehensive Management. J Gastrointest Canc 51, 829–835 (2020). https://doi.org/10.1007/s12029-019-00298-7

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Keywords

  • Comprehensive management
  • Curative
  • Hepatectomy
  • Hepatocellular carcinoma
  • Radiofrequency ablation
  • Surveillance
  • Survival rate