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Affiliations
Rareș Crăciun
Dept. of Internal Medicine, Iuliu Hațieganu University of Medicine and Pharmacy, Cluj-Napoca; Dept. of Gastroenterology, Prof. Dr. O. Fodor Regional Institute of Gastroenterology and Hepatology, Cluj-Napoca, Romania
Horia Ștefănescu
Department of Gastroenterology, ”Prof. Dr. O. Fodor” Regional Institute of Gastroenterology and Hepatology, Cluj-Napoca, Romania
Ioan Sporea
Dept. of Gastroenterology and Hepatology, Victor Babeș University of Medicine and Pharmacy, Timișoara, Romania
Larisa Daniela Săndulescu
Dept. of Gastroenterology, Research Center of Gastroenterology and Hepatology, Craiova University of Medicine and Pharmacy, Craiova, Romania
Liana Gheorghe
Center of Gastroenterology and Hepatology, Fundeni Clinical Institute, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
Anca Trifan
Institute of Gastroenterology and Hepatology, Emergency Clinical Hospital St. Spiridon, Grigore T. Popa University of Medicine and Pharmacy, Iasi, Romania
Zeno Spârchez
Dept. of Internal Medicine, Iuliu Hațieganu University of Medicine and Pharmacy, Cluj-Napoca; Dept. of Gastroenterology, Prof. Dr. O. Fodor Regional Institute of Gastroenterology and Hepatology, Cluj-Napoca, Romania
Mirela Dănilă
Dept. of Gastroenterology and Hepatology, Victor Babeș University of Medicine and Pharmacy, Timișoara, Romania
Ion Rogoveanu
Dept. of Gastroenterology, Research Center of Gastroenterology and Hepatology, Craiova University of Medicine and Pharmacy, Craiova, Romania
Răzvan Cerban
Center of Gastroenterology and Hepatology, Fundeni Clinical Institute, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
Camelia Cojocariu
Institute of Gastroenterology and Hepatology, Emergency Clinical Hospital St. Spiridon, Grigore T. Popa University of Medicine and Pharmacy, Iasi, Romania
Bogdan Procopeț
Dept. of Internal Medicine, Iuliu Hațieganu University of Medicine and Pharmacy, Cluj-Napoca; Dept. of Gastroenterology, Prof. Dr. O. Fodor Regional Institute of Gastroenterology and Hepatology, Cluj-Napoca, Romania
Roxana Șirli
Dept. of Gastroenterology and Hepatology, Victor Babeș University of Medicine and Pharmacy, Timișoara, Romania
Cristiana Marinela Urhuț
Dept. of Gastroenterology, Research Center of Gastroenterology and Hepatology, Craiova University of Medicine and Pharmacy, Craiova, Romania
Dana Crișan
Dept. of Internal Medicine, Iuliu Hațieganu University of Medicine and Pharmacy, Cluj-Napoca; Dept. of Gastroenterology, Clinical Municipal Hospital, Cluj-Napoca, Romania
Călin Burciu
Dept. of Gastroenterology and Hepatology, Victor Babeș University of Medicine and Pharmacy, Timișoara, Romania
Nadim Al-Hajjar
Dept. of Surgery, Iuliu Hațieganu University of Medicine and Pharmacy, Cluj-Napoca; Dept. of Surgery, ”Prof. Dr. O. Fodor” Regional Institute of Gastroenterology and Hepatology, Cluj-Napoca, Romania
Mircea Grigorescu
Dept. of Internal Medicine, Iuliu Hațieganu University of Medicine and Pharmacy, Cluj-Napoca; Dept. of Gastroenterology, Prof. Dr. O. Fodor Regional Institute of Gastroenterology and Hepatology, Cluj-Napoca, Romania
How to Cite
The Staging of Newly Diagnosed Hepatocellular Carcinoma in Romania. A National Multicentric Study
- Rareș Crăciun ,
- Horia Ștefănescu ,
- Ioan Sporea ,
- Larisa Daniela Săndulescu ,
- Liana Gheorghe ,
- Anca Trifan ,
- Zeno Spârchez ,
- Mirela Dănilă ,
- Ion Rogoveanu ,
- Răzvan Cerban ,
- Camelia Cojocariu ,
- Bogdan Procopeț ,
- Roxana Șirli ,
- Cristiana Marinela Urhuț ,
- Dana Crișan ,
- Călin Burciu ,
- Nadim Al-Hajjar ,
- Mircea Grigorescu
Abstract
Background and Aims: Hepatocellular carcinoma (HCC) is a significant public health issue, with an increasing incidence and prevalence and a high incidence-to-mortality ratio. The prognosis of HCC depends on two competing factors, tumor burden and underlying liver disease severity, encompassed in the Barcelona Clinic Liver Cancer (BCLC) classification. To assess HCC staging and the way staging affects eligibility for treatment at the time of the first diagnosis in Romania in the setting of opportunistic diagnosis, in the absence of a national HCC screening policy.
Methods: Data regarding HCC staging, underlying liver disease, and eligibility for treatment at the time of diagnosis was analyzed using a prospectively maintained multicentric database, which included patients from the five largest tertiary care hepatology units in the country between June 2016 and February 2020.
Results: A consecutive series of 477 patients was included. The distribution within BCLC classes was as follows: very early (0) 7.1%, early (A) 34.3%, intermediate (B) 19.4%, advanced (C) 14.2%, terminal (D) 24.7%. At the time of the diagnosis, 198 (41.5%) were eligible for a curative intent treatment, while 359 (75.2%) were eligible for a disease-modifying therapy. 228 patients (47.8%) had decompensated liver disease at the time of diagnosis, the most common decompensating event being ascites (78.1%).
Conclusions: A large proportion of HCC cases are diagnosed at the time of a decompensating event, severely restricting the therapeutic potential. Proactive diagnostic strategies should be implemented to improve the rate of actionable diagnosis.