Multidisciplinary approach is associated with improved survival of hepatocellular carcinoma patients

Dong Hyun Sinn, Gyu Seong Choi, Hee Chul Park, Jong Man Kim, Honsoul Kim, Kyoung Doo Song, Tae Wook Kang, Min Woo Lee, Hyunchul Rhim, Dongho Hyun, Sung Ki Cho, Sung Wook Shin, Woo Kyoung Jeong, Seong Hyun Kim, Jeong Il Yu, Sang Yun Ha, Su Jin Lee, Ho Yeong Lim, Kyunga Kim, Joong Hyun AhnWonseok Kang, Geum Youn Gwak, Yong Han Paik, Moon Seok Choi, Joon Hyeok Lee, Kwang Cheol Koh, Jae Won Joh, Hyo Keun Lim, Seung Woon Paik

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28 Scopus citations

Abstract

Background Given the complexity of managing hepatocellular carcinoma (HCC), a multidisciplinary approach (MDT) is recommended to optimize management of HCC patients. However, evidence suggesting that MDT improves patient outcome is limited. Methods We performed a retrospective cohort study of all patients newly-diagnosed with HCC between 2005 and 2013 (n = 6,619). The overall survival (OS) rates between the patients who were and were not managed via MDT were compared in the entire cohort (n = 6,619), and in the exactly matched cohort (n = 1,396). Results In the entire cohort, the 5-year survival rate was significantly higher in the patients who were managed via MDT compared to that of the patients who were not (71.2% vs. 49.4%, P < 0.001), with an adjusted hazard ratio (HR) of 0.47 (95% confidence interval [CI]; 0.41–0.53). In the exactly matched cohort, the 5-year survival rate was higher in patients who were managed via MDT (71.4% vs. 58.7%, P < 0.001; HR [95% CI] = 0.67 [0.56–0.80]). The survival benefit of MDT management was observed in most pre-defined subgroups, and was especially significant in patients with poor liver function (ALBI grade 2 or 3), intermediate or advanced tumor stage (BCLC stage B or C), or high alphafetoprotein levels (200 ng/ml). Conclusion MDT management was associated with improved overall survival in HCC patients, indicating that MDT management can be a valuable option to improve outcome of HCC patients. This warrants prospective evaluations.

Original languageEnglish
Article numbere0210730
JournalPLoS ONE
Volume14
Issue number1
DOIs
StatePublished - Jan 2019

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