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 Ahn; Wonseok 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

doi:10.1371/journal.pone.0210730

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

Department of Internal Medicine

Research output: Contribution to journal › Article › peer-review

68 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 language	English
Article number	e0210730
Journal	PLoS ONE
Volume	14
Issue number	1
DOIs	https://doi.org/10.1371/journal.pone.0210730
State	Published - Jan 2019

Bibliographical note

Publisher Copyright:
© 2019 Sinn et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Access to Document

10.1371/journal.pone.0210730

Cite this

Sinn, D. H., Choi, G. S., Park, H. C., Kim, J. M., Kim, H., Song, K. D., Kang, T. W., Lee, M. W., Rhim, H., Hyun, D., Cho, S. K., Shin, S. W., Jeong, W. K., Kim, S. H., Yu, J. I., Ha, S. Y., Lee, S. J., Lim, H. Y., Kim, K., ... Paik, S. W. (2019). Multidisciplinary approach is associated with improved survival of hepatocellular carcinoma patients. PLoS ONE, 14(1), Article e0210730. https://doi.org/10.1371/journal.pone.0210730

@article{652e1587218c4e25ad12b588520e5664,

title = "Multidisciplinary approach is associated with improved survival of hepatocellular carcinoma patients",

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.",

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

note = "Publisher Copyright: {\textcopyright} 2019 Sinn et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.",

year = "2019",

month = jan,

doi = "10.1371/journal.pone.0210730",

language = "English",

volume = "14",

journal = "PLoS ONE",

issn = "1932-6203",

publisher = "Public Library of Science",

number = "1",

}

Sinn, DH, Choi, GS, Park, HC, Kim, JM, Kim, H, Song, KD, Kang, TW, Lee, MW, Rhim, H, Hyun, D, Cho, SK, Shin, SW, Jeong, WK, Kim, SH, Yu, JI, Ha, SY, Lee, SJ, Lim, HY, Kim, K, Ahn, JH, Kang, W, Gwak, GY, Paik, YH, Choi, MS, Lee, JH, Koh, KC, Joh, JW, Lim, HK & Paik, SW 2019, 'Multidisciplinary approach is associated with improved survival of hepatocellular carcinoma patients', PLoS ONE, vol. 14, no. 1, e0210730. https://doi.org/10.1371/journal.pone.0210730

TY - JOUR

T1 - Multidisciplinary approach is associated with improved survival of hepatocellular carcinoma patients

AU - Sinn, Dong Hyun

AU - Choi, Gyu Seong

AU - Park, Hee Chul

AU - Kim, Jong Man

AU - Kim, Honsoul

AU - Song, Kyoung Doo

AU - Kang, Tae Wook

AU - Lee, Min Woo

AU - Rhim, Hyunchul

AU - Hyun, Dongho

AU - Cho, Sung Ki

AU - Shin, Sung Wook

AU - Jeong, Woo Kyoung

AU - Kim, Seong Hyun

AU - Yu, Jeong Il

AU - Ha, Sang Yun

AU - Lee, Su Jin

AU - Lim, Ho Yeong

AU - Kim, Kyunga

AU - Ahn, Joong Hyun

AU - Kang, Wonseok

AU - Gwak, Geum Youn

AU - Paik, Yong Han

AU - Choi, Moon Seok

AU - Lee, Joon Hyeok

AU - Koh, Kwang Cheol

AU - Joh, Jae Won

AU - Lim, Hyo Keun

AU - Paik, Seung Woon

N1 - Publisher Copyright: © 2019 Sinn et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

PY - 2019/1

Y1 - 2019/1

N2 - 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.

AB - 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.

UR - http://www.scopus.com/inward/record.url?scp=85059935610&partnerID=8YFLogxK

U2 - 10.1371/journal.pone.0210730

DO - 10.1371/journal.pone.0210730

M3 - Article

C2 - 30640924

AN - SCOPUS:85059935610

SN - 1932-6203

VL - 14

JO - PLoS ONE

JF - PLoS ONE

IS - 1

M1 - e0210730

ER -

Multidisciplinary approach is associated with improved survival of hepatocellular carcinoma patients

Abstract

Bibliographical note

Access to Document

Fingerprint

Cite this