Liver cancer: new advances in diagnosis, staging and treatment

15/4/2014

Data presented at the 2014 International Liver Congress focus on new approaches for improving diagnosis, staging & treatment of hepatocellular carcinoma (HCC).

Improving hepatocellular carcinoma patient outcomes

"Human hepatocellular carcinoma is one of the most prevalent cancers worldwide and the second most frequent cause of cancer-related death," said EASL's Scientific Committee Member Dr Helen Reeves Senior Lecturer & Honorary Consultant Gastroenterologist at Newcastle Hospitals NHS Foundation Trust, UK.

"Because HCC is such an extremely diverse and heterogeneous disease, improving patient outcomes has proved a difficult undertaking. A number of existing therapeutic options have been subjected to rigorous study but have not shown any patient benefit. The findings from these HCC diagnosis, staging and treatment studies are important because they have the potential to significantly improve patient outcomes," Dr Reeves explained. Key findings from the studies include:

  • the need for centrally-coordinated screening programs across Europe
  • the potential of "gadoxetic acid"-enhanced MRI to more accurately stage HCC patients with early disease to ensure each patient receives the optimum treatment
  • the development of a 3-gene signature blood test, which can be used as an alternative to imaging techniques to reliably identify early stage HCC in high-risk individuals
  • impressive long-term data reinforcing the importance of "percutaneous radiofrequency ablation" treatment in the HCC treatment armamentarium, including its use in the treatment of advanced HCC where a single HCC is associated with thrombosis of the main portal vein.

Detailed statistics on HCC

Wide geographical variation in HCC survival may be explained by differing intensity of country screening programs. In Japan, approximately 80% of hepatocellular carcinoma (HCC) cases are detected by screening. In marked contrast, the figures for the UK, Spain and Hong Kong data were significantly lower at 15%, 35% and less than 10% respectively.

There was also a dramatic difference in the stage of disease at diagnosis. In Japanese patients, 59% were within the "Milan Criteria" (generally accepted set of parameters designed to assess the suitability of HCC patients for liver transplantation) and 71% were suitable for potentially curative treatment. Comparative figures for Spain were much lower at 26 and 32%, the UK 37 and 38% and Hong Kong, 8 and 16%, respectively.

Median HCC survival for Japan, Spain, UK and Hong Kong were 47, 26, 20 and 7 months respectively.

As Dr Reeves explained, the wide geographical variation in survival among HCC patients had been attributed to intrinsic ethnic differences, different reasons, or disease stages at presentation. "However, age, gender and Child-Pugh class distribution were all similar between the HCC patient populations from each of these four countries." Statistical analysis showed that the cause of the disease had little impact on survival, as Dr Reeves mentioned.

 

Source: Medical News Today: http://www.medicalnewstoday.com/releases/275469.php

No Comment