PDF(Pubmed)
Abstract：
UNASSIGNED: Increasing incidence of hepatocellular carcinoma (HCC) in India is a matter of concern and need for adequate profiling and streamlining management strategies cannot be over-emphasized.
UNASSIGNED: This is a prospective multi-centric observational cohort study comprising of an oncology center, one university tertiary hospital with specialized hepatology service, one public hospital with gastroenterology service, and a private liver transplant center located within a 3-km radius. The demographic and clinical parameters were recorded on a prospectively maintained database. The clinical profile, demographics, characteristics of HCC and the allocated treatment were noted and compared among the four centers.
UNASSIGNED: In total, 672 patients were enrolled from June 2016 till January 2020. Abdominal pain (64.3%) and weight loss (47.3%) were the most common symptoms. Most common identified etiology was hepatitis B (39%). The cancer center received lesser patients with hepatitis C and those with advanced stage of HCC. The private transplant center reported the highest proportion of NASH, which was also significantly higher in those belonging to higher socioeconomic strata, and lowest proportion of alcoholic cirrhosis. Metastasis was seen in almost one-fifth (19%) cases at diagnosis. Portal vein thrombosis was evident in 40%. Adherence to treatment guidelines was seen in three-fourth cases (76%).
UNASSIGNED: Hepatitis B is the most common underlying cause for HCC, whereas other causes like NASH are on the rise. Etiologic profile may vary with selective specialization of centers catering to patients with HCC. Adherence to guideline while allocating treatment was high among all centers with highest non-adherence in BCLC A.
UNASSIGNED: This is a prospective multi-centric observational cohort study comprising of an oncology center, one university tertiary hospital with specialized hepatology service, one public hospital with gastroenterology service, and a private liver transplant center located within a 3-km radius. The demographic and clinical parameters were recorded on a prospectively maintained database. The clinical profile, demographics, characteristics of HCC and the allocated treatment were noted and compared among the four centers.
UNASSIGNED: In total, 672 patients were enrolled from June 2016 till January 2020. Abdominal pain (64.3%) and weight loss (47.3%) were the most common symptoms. Most common identified etiology was hepatitis B (39%). The cancer center received lesser patients with hepatitis C and those with advanced stage of HCC. The private transplant center reported the highest proportion of NASH, which was also significantly higher in those belonging to higher socioeconomic strata, and lowest proportion of alcoholic cirrhosis. Metastasis was seen in almost one-fifth (19%) cases at diagnosis. Portal vein thrombosis was evident in 40%. Adherence to treatment guidelines was seen in three-fourth cases (76%).
UNASSIGNED: Hepatitis B is the most common underlying cause for HCC, whereas other causes like NASH are on the rise. Etiologic profile may vary with selective specialization of centers catering to patients with HCC. Adherence to guideline while allocating treatment was high among all centers with highest non-adherence in BCLC A.
摘要：
■在印度肝细胞癌（HCC）的发病率增加是一个值得关注的问题，需要适当的分析和简化管理策略不能过分强调。
■这是一项由肿瘤学中心组成的前瞻性多中心观察性队列研究，一所拥有专门肝病服务的大学三级医院，一家提供消化内科服务的公立医院，和一个位于3公里半径内的私人肝移植中心。人口统计学和临床参数记录在前瞻性维护的数据库中。临床资料,人口统计，我们记录并比较了4个中心的HCC特征和所分配的治疗方案.
■总共，从2016年6月至2020年1月招募672名患者。腹痛（64.3%）和体重减轻（47.3%）是最常见的症状。最常见的病因是乙型肝炎（39％）。癌症中心接受了较少的丙型肝炎患者和晚期HCC患者。私人移植中心报告的NASH比例最高，在属于较高社会经济阶层的人群中，酒精性肝硬化的比例最低。在诊断时，几乎五分之一（19％）的病例出现转移。门静脉血栓形成占40%。在四分之三的病例（76％）中发现了对治疗指南的坚持。
■乙型肝炎是肝癌最常见的根本原因，而NASH等其他原因正在上升。病因学特征可能随迎合HCC患者的中心的选择性专业化而变化。在BCLCA中，所有不依从性最高的中心中，分配治疗时对指南的依从性都很高。
■这是一项由肿瘤学中心组成的前瞻性多中心观察性队列研究，一所拥有专门肝病服务的大学三级医院，一家提供消化内科服务的公立医院，和一个位于3公里半径内的私人肝移植中心。人口统计学和临床参数记录在前瞻性维护的数据库中。临床资料,人口统计，我们记录并比较了4个中心的HCC特征和所分配的治疗方案.
■总共，从2016年6月至2020年1月招募672名患者。腹痛（64.3%）和体重减轻（47.3%）是最常见的症状。最常见的病因是乙型肝炎（39％）。癌症中心接受了较少的丙型肝炎患者和晚期HCC患者。私人移植中心报告的NASH比例最高，在属于较高社会经济阶层的人群中，酒精性肝硬化的比例最低。在诊断时，几乎五分之一（19％）的病例出现转移。门静脉血栓形成占40%。在四分之三的病例（76％）中发现了对治疗指南的坚持。
■乙型肝炎是肝癌最常见的根本原因，而NASH等其他原因正在上升。病因学特征可能随迎合HCC患者的中心的选择性专业化而变化。在BCLCA中，所有不依从性最高的中心中，分配治疗时对指南的依从性都很高。
