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- Title
Multidisciplinary approach is associated with improved survival of hepatocellular carcinoma patients.
- Authors
Sinn, Dong Hyun; Choi, Gyu-Seong; Park, Hee Chul; Kim, Jong Man; Kim, Honsoul; Song, Kyoung Doo; Kang, Tae Wook; Lee, Min Woo; Rhim, Hyunchul; Hyun, Dongho; Cho, Sung Ki; Shin, Sung Wook; Jeong, Woo Kyoung; Kim, Seong Hyun; Yu, Jeong Il; Ha, Sang Yun; Lee, Su Jin; Lim, Ho Yeong; Kim, Kyunga; Ahn, Joong Hyun
- 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.
- Subjects
LIVER cancer; MEDICAL care; COHORT analysis; DEMOGRAPHY; PUBLIC health
- Publication
PLoS ONE, 2019, Vol 14, Issue 1, p1
- ISSN
1932-6203
- Publication type
Article
- DOI
10.1371/journal.pone.0210730