AI Article Synopsis
- Multidisciplinary care (MDC) is recommended for managing hepatocellular carcinoma (HCC) due to its complexity, despite requiring substantial time and resources for implementation.
- A systematic review of 12 studies (involving 15,365 HCC patients) indicated that MDC is linked to improved overall survival; however, its impact on receiving curative treatment wasn't statistically significant.
- The findings suggest that while MDC can enhance survival rates, there are limitations in the studies, including variations in outcomes and potential biases affecting early-stage treatment initiation.
Article Abstract
Background: Given the complexity of managing HCC, professional society guidelines advocate multidisciplinary care (MDC) for patients with HCC. However, implementation of MDC programs requires a significant investment of time and resources. We conducted a systematic review and meta-analysis to enumerate potential benefits of MDC for patients with HCC.
Methods: We conducted a search of the PubMed/MEDLINE and EMBASE databases and national conference abstracts to identify studies published after January 2005 that reported early-stage presentation, treatment receipt, or overall survival among patients with HCC, stratified by MDC status. We calculated pooled risk ratios and HRs for clinical outcomes according to MDC receipt using the DerSimonian and Laird method for random effects models.
Results: We identified 12 studies (n = 15,365 patients with HCC) with outcomes stratified by MDC status. MDC was associated with improved overall survival (HR = 0.63, 95% CI: 0.45-0.88); however, its association with curative treatment receipt was not statistically significant (risk ratio = 1.60, 95% CI: 0.89-2.89) and pooled estimates were limited by high heterogeneity (I2 > 90% for both). Studies (n = 3) were discordant regarding an association between MDC and time-to-treatment initiation. MDC was associated with early-stage HCC (risk ratio = 1.60, 95% CI: 1.12-2.29), suggesting possible referral bias contributing to improved outcomes. Limitations of studies also included risk of residual confounding, loss to follow-up, and data preceding the availability of immune checkpoint inhibitors.
Conclusion: MDC for patients with HCC is associated with improved overall survival, underscoring the likely benefit of managing patients with HCC in a multidisciplinary care setting.
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|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10146543 | PMC |
| http://dx.doi.org/10.1097/HC9.0000000000000143 | DOI Listing |
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