Meza JJ, Montaño LA, Green RD

Language: Spanish
References: 14
Page: 160-168
PDF size: 72.70 Kb.

ABSTRACT

Background: Several pronostic classifications for the hepatocellular carcinoma (Okuda, TNM, Barcelona, French, Italian and Japanese), which do not allow to determine a precise prognosis for individual patients, but they are useful as a guide for the prognosis and treatment of sub-groups of patients. The main tumor factors to consider in a model prognosis are: size, the multicentricity, the presence or absence of tumor invasion, the degree of differentiation and the metastasis out of the liver; and the factors of the patient are: the physical state, morbidities, the presence or absence of cirrhosis and the effectiveness of the therapeutic interventions. Objective: To evaluate the utility of the different classifications from Okuda, Italian (CLIP), Barcelona (BCLC), French, TNM, and in patients with cirrhosis, Child-Pugh in the therapeutic decision and the prognosis of patients with hepatocellular carcinoma (HCC) in a cohort of 148 subjects taken care of in the National Institute of Medical Sciences and Nutrition, Salvador Zubirán in a period of 10 years. Patients and Methods: In retrospective form, we reviewed the clinical files of 148 consecutive patients with HCC diagnosis and treaties in a period of 10 years. The patients were classified according to the Child-Pugh, Okuda, TNM, BCLC, CLIP and French classifications. The patients received treatment to discretion of the oncologist doctor and consisted of surgery, percutaneous etanol injection, tamoxifen, systemic chemotherapy, arterial chemoembolization, thalidomide or symptomatic treatment. Results: The classifications of Child-Pugh, Okuda, TNM, CLIP, the percentage of liver damage, the ascitis presence, the ECOG and the type of treatment were predicting of survival in the univariate analysis; but the multivariate analysis selected to the alkaline phosphatase and alphafetoprotein (AFP) elevation, the Child classification and the surgical treatment like independent factors to predicting survival. The medium one of survival was of 15.43 months. Conclusion: Child-Pugh classification was of prognostic utility in ours patients. The surgical resection is one of the curative therapeutic modalities in the HCC with compensated liver function. The elevation of the alkaline phosphatase and AFP were important in the prognosis of these patients.

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