Impact of hepatologists to extend survival of hepatocellular carcinoma patients with cirrhosis: a comparison with non-hepatologists

[Guest guest]

Hepatogastroenterology. 2004 Mar-Apr;51(56):564-9.

Impact of hepatologists to extend survival of hepatocellular carcinoma

patients with cirrhosis: a comparison with non-hepatologists.

Dohmen K, Shirahama M, Shigematsu H, Irie K, Ishibashi H.

Clinical Research Center, National Nagasaki Medical Center, Omura, Japan.

dohmenk@...

BACKGROUND/AIMS: Whether or not generalists and specialist physicians can

make an appropriate adaptation of their practice patterns when caring for

their patients currently remains a matter of debate. The present study was

undertaken to explore whether the clinical characteristics of hepatocellular

carcinoma at its time of detection, the initial treatment options and the

survival vary between patients with hepatocellular carcinoma associated with

cirrhosis who were treated by hepatologists and those who were treated by

non-hepatologists. METHODOLOGY: A retrospective study with 626 patients with

hepatocellular carcinoma associated with cirrhosis was performed. The

patients were stratified into three groups as follows; 1) a hepatologist

group: 280 patients followed up and treated consistently by hepatologists,

2) a non-hepatologist group: 126 patients followed up and treated

consistently by non-hepatologists, and 3) the other group: 220 patients

either followed up by hepatologists and treated by non-hepatologists, or

vice versa, or those identified to have tumors incidentally without any

follow-up. To confirm the clear difference between generalists and

specialists, the gender ratio, age, hepatitis B and C virus markers, serum

alpha-fetoprotein level, tumor size, the number of tumors, Child's grade,

portal thrombosis at the initial detection, the types of follow-up until the

initial detection of hepatocellular carcinoma, the initial treatments

chosen, and survival were compared between the hepatologist group and the

non-hepatologist group. RESULTS: There were no statistically significant

differences between the two groups with respect to gender ratio, age,

hepatitis virus markers and the alpha-fetoprotein level. However, the tumor

size, the number of tumors, Child's grade and portal thrombosis at the

initial detection were more advanced in the non-hepatologist group, which

was most likely due to the poorer follow-up until the detection of

hepatocellular carcinoma compared with that in the hepatologist group (p

value: 0.0237). Regarding therapy for hepatocellular carcinoma, intensive

therapies were more often performed in the hepatologist group and, in

addition, non-treated cases were less frequently found in the hepatologist

group. Consequently, the 1-, 3- and 5-year survivals of the patients in the

hepatologist group were 84.7, 61.1 and 35.1%, respectively, which were

significantly longer than those in the non-hepatologist group, which were

80.7, 45.8 and 31.8%, respectively (p value: 0.0434). CONCLUSIONS:

Hepatocellular carcinoma patients with cirrhosis who were treated by

hepatologists can expect to obtain a longer survival because hepatocellular

carcinoma tends to be detected at a smaller size, while such patients also

usually receive more appropriate treatment modalities.

PMID: 15086203 [PubMed - in process

[Guest guest]

Hepatogastroenterology. 2004 Mar-Apr;51(56):564-9.

Impact of hepatologists to extend survival of hepatocellular carcinoma

patients with cirrhosis: a comparison with non-hepatologists.

Dohmen K, Shirahama M, Shigematsu H, Irie K, Ishibashi H.

Clinical Research Center, National Nagasaki Medical Center, Omura, Japan.

dohmenk@...

BACKGROUND/AIMS: Whether or not generalists and specialist physicians can

make an appropriate adaptation of their practice patterns when caring for

their patients currently remains a matter of debate. The present study was

undertaken to explore whether the clinical characteristics of hepatocellular

carcinoma at its time of detection, the initial treatment options and the

survival vary between patients with hepatocellular carcinoma associated with

cirrhosis who were treated by hepatologists and those who were treated by

non-hepatologists. METHODOLOGY: A retrospective study with 626 patients with

hepatocellular carcinoma associated with cirrhosis was performed. The

patients were stratified into three groups as follows; 1) a hepatologist

group: 280 patients followed up and treated consistently by hepatologists,

2) a non-hepatologist group: 126 patients followed up and treated

consistently by non-hepatologists, and 3) the other group: 220 patients

either followed up by hepatologists and treated by non-hepatologists, or

vice versa, or those identified to have tumors incidentally without any

follow-up. To confirm the clear difference between generalists and

specialists, the gender ratio, age, hepatitis B and C virus markers, serum

alpha-fetoprotein level, tumor size, the number of tumors, Child's grade,

portal thrombosis at the initial detection, the types of follow-up until the

initial detection of hepatocellular carcinoma, the initial treatments

chosen, and survival were compared between the hepatologist group and the

non-hepatologist group. RESULTS: There were no statistically significant

differences between the two groups with respect to gender ratio, age,

hepatitis virus markers and the alpha-fetoprotein level. However, the tumor

size, the number of tumors, Child's grade and portal thrombosis at the

initial detection were more advanced in the non-hepatologist group, which

was most likely due to the poorer follow-up until the detection of

hepatocellular carcinoma compared with that in the hepatologist group (p

value: 0.0237). Regarding therapy for hepatocellular carcinoma, intensive

therapies were more often performed in the hepatologist group and, in

addition, non-treated cases were less frequently found in the hepatologist

group. Consequently, the 1-, 3- and 5-year survivals of the patients in the

hepatologist group were 84.7, 61.1 and 35.1%, respectively, which were

significantly longer than those in the non-hepatologist group, which were

80.7, 45.8 and 31.8%, respectively (p value: 0.0434). CONCLUSIONS:

Hepatocellular carcinoma patients with cirrhosis who were treated by

hepatologists can expect to obtain a longer survival because hepatocellular

carcinoma tends to be detected at a smaller size, while such patients also

usually receive more appropriate treatment modalities.

PMID: 15086203 [PubMed - in process

[Guest guest]

Hepatogastroenterology. 2004 Mar-Apr;51(56):564-9.

Impact of hepatologists to extend survival of hepatocellular carcinoma

patients with cirrhosis: a comparison with non-hepatologists.

Dohmen K, Shirahama M, Shigematsu H, Irie K, Ishibashi H.

Clinical Research Center, National Nagasaki Medical Center, Omura, Japan.

dohmenk@...

BACKGROUND/AIMS: Whether or not generalists and specialist physicians can

make an appropriate adaptation of their practice patterns when caring for

their patients currently remains a matter of debate. The present study was

undertaken to explore whether the clinical characteristics of hepatocellular

carcinoma at its time of detection, the initial treatment options and the

survival vary between patients with hepatocellular carcinoma associated with

cirrhosis who were treated by hepatologists and those who were treated by

non-hepatologists. METHODOLOGY: A retrospective study with 626 patients with

hepatocellular carcinoma associated with cirrhosis was performed. The

patients were stratified into three groups as follows; 1) a hepatologist

group: 280 patients followed up and treated consistently by hepatologists,

2) a non-hepatologist group: 126 patients followed up and treated

consistently by non-hepatologists, and 3) the other group: 220 patients

either followed up by hepatologists and treated by non-hepatologists, or

vice versa, or those identified to have tumors incidentally without any

follow-up. To confirm the clear difference between generalists and

specialists, the gender ratio, age, hepatitis B and C virus markers, serum

alpha-fetoprotein level, tumor size, the number of tumors, Child's grade,

portal thrombosis at the initial detection, the types of follow-up until the

initial detection of hepatocellular carcinoma, the initial treatments

chosen, and survival were compared between the hepatologist group and the

non-hepatologist group. RESULTS: There were no statistically significant

differences between the two groups with respect to gender ratio, age,

hepatitis virus markers and the alpha-fetoprotein level. However, the tumor

size, the number of tumors, Child's grade and portal thrombosis at the

initial detection were more advanced in the non-hepatologist group, which

was most likely due to the poorer follow-up until the detection of

hepatocellular carcinoma compared with that in the hepatologist group (p

value: 0.0237). Regarding therapy for hepatocellular carcinoma, intensive

therapies were more often performed in the hepatologist group and, in

addition, non-treated cases were less frequently found in the hepatologist

group. Consequently, the 1-, 3- and 5-year survivals of the patients in the

hepatologist group were 84.7, 61.1 and 35.1%, respectively, which were

significantly longer than those in the non-hepatologist group, which were

80.7, 45.8 and 31.8%, respectively (p value: 0.0434). CONCLUSIONS:

Hepatocellular carcinoma patients with cirrhosis who were treated by

hepatologists can expect to obtain a longer survival because hepatocellular

carcinoma tends to be detected at a smaller size, while such patients also

usually receive more appropriate treatment modalities.

PMID: 15086203 [PubMed - in process

[Guest guest]

Hepatogastroenterology. 2004 Mar-Apr;51(56):564-9.

Impact of hepatologists to extend survival of hepatocellular carcinoma

patients with cirrhosis: a comparison with non-hepatologists.

Dohmen K, Shirahama M, Shigematsu H, Irie K, Ishibashi H.

Clinical Research Center, National Nagasaki Medical Center, Omura, Japan.

dohmenk@...

BACKGROUND/AIMS: Whether or not generalists and specialist physicians can

make an appropriate adaptation of their practice patterns when caring for

their patients currently remains a matter of debate. The present study was

undertaken to explore whether the clinical characteristics of hepatocellular

carcinoma at its time of detection, the initial treatment options and the

survival vary between patients with hepatocellular carcinoma associated with

cirrhosis who were treated by hepatologists and those who were treated by

non-hepatologists. METHODOLOGY: A retrospective study with 626 patients with

hepatocellular carcinoma associated with cirrhosis was performed. The

patients were stratified into three groups as follows; 1) a hepatologist

group: 280 patients followed up and treated consistently by hepatologists,

2) a non-hepatologist group: 126 patients followed up and treated

consistently by non-hepatologists, and 3) the other group: 220 patients

either followed up by hepatologists and treated by non-hepatologists, or

vice versa, or those identified to have tumors incidentally without any

follow-up. To confirm the clear difference between generalists and

specialists, the gender ratio, age, hepatitis B and C virus markers, serum

alpha-fetoprotein level, tumor size, the number of tumors, Child's grade,

portal thrombosis at the initial detection, the types of follow-up until the

initial detection of hepatocellular carcinoma, the initial treatments

chosen, and survival were compared between the hepatologist group and the

non-hepatologist group. RESULTS: There were no statistically significant

differences between the two groups with respect to gender ratio, age,

hepatitis virus markers and the alpha-fetoprotein level. However, the tumor

size, the number of tumors, Child's grade and portal thrombosis at the

initial detection were more advanced in the non-hepatologist group, which

was most likely due to the poorer follow-up until the detection of

hepatocellular carcinoma compared with that in the hepatologist group (p

value: 0.0237). Regarding therapy for hepatocellular carcinoma, intensive

therapies were more often performed in the hepatologist group and, in

addition, non-treated cases were less frequently found in the hepatologist

group. Consequently, the 1-, 3- and 5-year survivals of the patients in the

hepatologist group were 84.7, 61.1 and 35.1%, respectively, which were

significantly longer than those in the non-hepatologist group, which were

80.7, 45.8 and 31.8%, respectively (p value: 0.0434). CONCLUSIONS:

Hepatocellular carcinoma patients with cirrhosis who were treated by

hepatologists can expect to obtain a longer survival because hepatocellular

carcinoma tends to be detected at a smaller size, while such patients also

usually receive more appropriate treatment modalities.

PMID: 15086203 [PubMed - in process