The adherence to the American Association for the Study of Liver Diseases 2018 guidelines in the management of hepatocellular carcinoma and its impact on survival

Ashish Manne, Madhuri Mulekar, Daisy Escobar, Pranitha Prodduturvar, Yazan Fahmawi, Phillip Henderson, Osama Abdul-Rahim, Zeiad Hussain, Spencer Liles, Annabelle Fonseca, John Harrison Howard, Wadad Mneimneh, Robert Gilbert, Omar Alkharabsheh, Sachin Pai, Zachary B. White, Cindy Nelson, Moh'd Khushman

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Introduction: In two Korean and Italian studies, the adherence rate (AR) to ASSLD 2005 guidelines in the management of hepatocellular carcinoma (HCC) was 60%. In a US study, the AR to American Association for the Study of Liver Disease (AASLD) 2005 guidelines was 73.3%, 26.8%, 25.3%, and 58.8% for patients with Barcelona Clinic Liver Cancer (BCLC) Stage A, B, C, and D, respectively, and nonadherence to guidelines was associated with longer overall survival (OS) in patients with BCLC Stage D. Here, we explored the AR to AASLD 2018 guidelines and its impact on OS. Methods: Between 2017 and 2019, 148 unique treatment-naïve patients with HCC were identified. Patients were staged according to the BCLC staging system and their AR to AASLD 2018 guidelines was noted. OS was estimated using Kaplan-Meier method. Survivals among patients from different groups was compared using Log-rank test. Results: The overall AR to AASLD 2018 guidelines was 83%. The AR for BCLC Stages 0, A, B, C, and D were 100%, 97%, 77%, 77%, and 38%, respectively. In patients with BCLC Stage D, the OS of patients treated with modalities adherent versus nonadherent to AASLD 2018 guidelines was 0.03 vs. 5.2 months (P = 0.0005). Otherwise, adherence versus nonadherence to AASLD 2018 guidelines showed no statistically significant differences in OS for patients with BCLC Stages 0, A, B, and C. Conclusion: The overall AR to AASLD 2018 guidelines was 83%. Nonadherence to AASLD 2018 guidelines in patients with BCLC Stage D translated into better OS.

Original languageEnglish
Pages (from-to)1103-1108
Number of pages6
JournalJournal of cancer research and therapeutics
Volume19
Issue number5
DOIs
StatePublished - 2023

Keywords

  • Adherence to guidelines
  • American Association for the Study of Liver Disease guidelines
  • Barcelona Clinic Liver Cancer staging
  • adherence to guidelines
  • hepatocellular carcinoma

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