Multidisciplinary approach is associated with improved survival of hepatocellular carcinoma patients

PLoS One. 2019 Jan 14;14(1):e0210730. doi: 10.1371/journal.pone.0210730. eCollection 2019.

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.

MeSH terms

  • Aged
  • Carcinoma, Hepatocellular / blood
  • Carcinoma, Hepatocellular / drug therapy
  • Carcinoma, Hepatocellular / mortality*
  • Carcinoma, Hepatocellular / therapy
  • Female
  • Fetal Proteins / blood
  • Humans
  • Kaplan-Meier Estimate
  • Liver Neoplasms / blood
  • Liver Neoplasms / drug therapy
  • Liver Neoplasms / mortality*
  • Liver Neoplasms / therapy
  • Male
  • Middle Aged
  • Proportional Hazards Models
  • ROC Curve
  • Retrospective Studies
  • Survival Rate

Substances

  • Fetal Proteins

Grants and funding

The authors received no specific funding for this work.