Evidence map›Paper›PMID 28547649›Full record

ArticleDigestive diseases and sciences2017

HKLC Triages More Hepatocellular Carcinoma Patients to Curative Therapies Compared to BCLC and Is Associated with Better Survival.

Michael C Wallace, Yi Huang, David B Preen, George Garas, Leon A Adams, Gerry MacQuillan, Jonathan Tibballs, John Ferguson, Shaun Samuelson, Gary P Jeffrey

Abstract readComparative Study
PubMed Publisher
In one paragraph

Article in Digestive diseases and sciences, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Article
  4. Management of patients with intermediate stage hepatocellular carcinoma.Therapeutic advances in medical oncology · 2020
    Review
  5. Article
  6. Staging systems of hepatocellular carcinoma: A review.Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology · 2018
    Review
  7. Article
  8. Article
  9. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Michael C WallaceDepartment of Hepatology, Sir Charles Gairdner Hospital, Hospital Avenue, Nedlands, Perth, WA, 6009, Australia. michael.wallace2@health.wa.gov.au.
Yi HuangSchool of Medicine and Pharmacology, University of Western Australia, Nedlands, WA, Australia.
David B PreenSchool of Population Health, University of Western Australia, Nedlands, WA, Australia.
George GarasDepartment of Hepatology, Sir Charles Gairdner Hospital, Hospital Avenue, Nedlands, Perth, WA, 6009, Australia.
Leon A AdamsDepartment of Hepatology, Sir Charles Gairdner Hospital, Hospital Avenue, Nedlands, Perth, WA, 6009, Australia.
Gerry MacQuillanDepartment of Hepatology, Sir Charles Gairdner Hospital, Hospital Avenue, Nedlands, Perth, WA, 6009, Australia.
Jonathan TibballsDepartment of Radiology, Sir Charles Gairdner Hospital, Nedlands, WA, Australia.
John FergusonDepartment of Radiology, Sir Charles Gairdner Hospital, Nedlands, WA, Australia.
Shaun SamuelsonDepartment of Radiology, Sir Charles Gairdner Hospital, Nedlands, WA, Australia.
Gary P JeffreyDepartment of Hepatology, Sir Charles Gairdner Hospital, Hospital Avenue, Nedlands, Perth, WA, 6009, Australia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND AND

aimsThe Hong Kong Liver Cancer (HKLC) system proposes to triage hepatocellular carcinoma (HCC) patients to more aggressive treatment and may be associated with superior survival compared with the Barcelona Clinic Liver Cancer (BCLC) system. We aimed to identify the influence of adherence to HKLC or BCLC treatment recommendations on survival and time to progression.

methodsWe examined a prospectively enrolled cohort of 292 patients undergoing 532 treatment episodes from a single clinical center.

resultsThe BCLC and HKLC systems accurately predicted overall survival and time to progression after each treatment episode (BCLC: p < 0.001; HKLC: p < 0.001). Adherence to treatment recommendations was higher for HKLC than for BCLC (55.6 vs. 47.9%, p = 0.01). Survival was superior with adherence to HKLC recommendations compared to non-adherence (45.3 vs. 27.1 months, p < 0.001). There was no difference in survival in BCLC with adherence compared to non-adherence (34.6 vs. 32.3 months, p = 0.96). The survival benefit was limited to early- and very early stage disease for both HKLC (p < 0.001) and BCLC (p = 0.007). More patients were triaged to curative therapies by HKLC than BCLC (p = 0.004). The use of transarterial chemoembolization instead of ablation or resection in early- and very early stage disease for technical reasons was the major cause for non-recommended treatment and was associated with worse survival (p < 0.001).

conclusionsThese data support the use of HKLC in early- and very early stage HCC. Efforts should be made to overcome technical reasons for not performing ablation in early- and very early stage disease.

Indexed as

AdultCarcinoma, HepatocellularChemoembolization, TherapeuticDisease ProgressionEarly Detection of CancerFemaleGuideline AdherenceHong KongHumansKaplan-Meier EstimateLiver NeoplasmsMaleMiddle AgedNeoplasm StagingProspective StudiesRetrospective StudiesCancer guidelinesCancer stagingCancer treatmentEpidemiologyTransarterial chemoembolization

Identifiers

PMID28547649

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.