Evidence map›Paper›PMID 35800821›Full record

ArticleCureus2022

Multimodal Treatment of Hepatocellular Carcinoma in Patients With Hepatitis C Virus Infection Treated With Direct-Acting Antivirals.

Adriana Mercan-Stanciu, Teodora Isac, Razvan Rababoc, Daniel Rusie, Letitia Toma, Ileana Adela Vacaroiu, Raluca Tulin, Elena Laura Iliescu

Open access · diamondAbstract read
In one paragraph

Article in Cureus, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact, top 92% of its field
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

0 citing papers in PubMed, 0 citations in OpenAlex.

No citing paper in PubMed yet.

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

8 authors at 3 institutions in 1 country.

Adriana Mercan-StanciuDepartment of Internal Medicine II, Fundeni Clinical Institute, Bucharest, ROU.
Teodora IsacDepartment of Internal Medicine II, Carol Davila University of Medicine and Pharmacy, Bucharest, ROU.
Razvan RababocDepartment of Internal Medicine II, Fundeni Clinical Institute, Bucharest, ROU.
Daniel RusieGeneral Surgery, Bucharest Emergency Clinical Hospital, Bucharest, ROU.
Letitia TomaDepartment of Internal Medicine II, Fundeni Clinical Institute, Bucharest, ROU.
Ileana Adela VacaroiuDepartment of Nephrology, Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, Bucharest, ROU.
Raluca TulinDepartment of Anatomy and Embryology, Carol Davila University of Medicine and Pharmacy, Bucharest, ROU.
Elena Laura IliescuDepartment of Internal Medicine II, Fundeni Clinical Institute, Bucharest, ROU.
Carol Davila University of Medicine and Pharmacy · ROInstitutul Clinic Fundeni · ROClinical Emergency Hospital Bucharest · RO

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundDirect-acting antivirals (DAAs) opened a new era in the management of hepatitis C virus (HCV)-associated liver disease. However, hepatic cancer screening should not be stopped after obtaining a sustained virologic response (SVR). Current guidelines offer several treatment options for hepatocellular carcinoma (HCC), mainly depending on its stage and the extent of liver disease, including tumor resection, liver transplantation (LT), radiofrequency ablation (RFA), transarterial chemoembolization (TACE), and systemic agents. This article provides an overview of treatment modalities for hepatocellular carcinoma and associated survival rates based on the experience of the Internal Medicine Center at Fundeni Clinical Institute while bringing into light previous medical research.

methodsWe included 59 patients with a personal history of hepatitis C virus infection, diagnosed with hepatocellular carcinoma at least one year after achieving a sustained virologic response through direct-acting antivirals. The albumin-bilirubin (ALBI) score and Barcelona Clinic Liver Cancer (BCLC) classification were assessed in each case, and all patients were treated accordingly. The subjects were monitored by liver function tests, tumor markers, blood cell count, coagulation profile, and imaging explorations. We investigated the Eastern Cooperative Oncology Group (ECOG) performance status, the response to applied treatments, and survival.

resultsCirrhotic patients and multinodular tumor patterns were predominant. Most patients only experienced one therapeutic procedure, while the rest of the study group went through multiple treatment modalities (2-4), with a better outcome in terms of survival parameters. A large proportion presented with disease progression despite the therapeutic measures applied. A total of two liver transplants were performed, resulting in a 12-month disease-free period among these patients. The presence of diabetes mellitus (DM), multinodular disease, alpha-fetoprotein (AFP) over 300 ng/mL, and tumor dimension over 6 cm indicate poor overall survival. Both overall survival and progression-free survival were better in subjects who presented complete responses (CR) to HCC treatment. In patients undergoing a single intervention, the best overall survival was associated with surgical resection and RFA.

conclusionThe multimodal treatment of hepatocellular carcinoma represents the best approach, in order to maintain patients on the waiting list for liver transplantation. In hepatitis C virus infection, viral clearance is important to obtain. At the same time, particular attention should be paid to liver cancer screening even after obtaining a sustained virologic response.

Indexed as

direct-acting antiviralshepatitis c virus infectionhepatocellular carcinomaliver transplantationsorafenib

Identifiers

PMID35800821
PMCPMC9246468
OpenAlexW4281690104

What OpenQuestion holds

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LicenceCC BY
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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.