Multidisciplinary care for patients with HCC: a systematic review and meta-analysis.
| Title: | Multidisciplinary care for patients with HCC: a systematic review and meta-analysis. |
|---|---|
| Authors: | Seif El Dahan K; Department of Internal Medicine, UT Southwestern Medical Center, Dallas, Texas, USA.; Reczek A; Department of Internal Medicine, UT Southwestern Medical Center, Dallas, Texas, USA.; Daher D; Department of Internal Medicine, UT Southwestern Medical Center, Dallas, Texas, USA.; Rich NE; Department of Internal Medicine, UT Southwestern Medical Center, Dallas, Texas, USA.; Yang JD; Department of Internal Medicine, Cedars Sinai Medical Center, Los Angeles, California,USA.; Hsiehchen D; Department of Internal Medicine, UT Southwestern Medical Center, Dallas, Texas, USA.; Zhu H; Department of Internal Medicine, UT Southwestern Medical Center, Dallas, Texas, USA.; Patel MS; Department of Surgery, UT Southwestern Medical Center, Dallas, Texas, USA.; Bayona Molano MDP; Department of Radiology, UT Southwestern Medical Center, Dallas, Texas, USA.; Sanford N; Department of Radiation Oncology, UT Southwestern Medical Center, Dallas, Texas, USA.; Gopal P; Department of Pathology, UT Southwestern Medical Center, Dallas, Texas, USA.; Parikh ND; Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, USA.; Yopp AC; Department of Surgery, UT Southwestern Medical Center, Dallas, Texas, USA.; Singal AG; Department of Internal Medicine, UT Southwestern Medical Center, Dallas, Texas, USA. |
| Source: | Hepatology communications [Hepatol Commun] 2023 Apr 26; Vol. 7 (5). Date of Electronic Publication: 2023 Apr 26 (Print Publication: 2023). |
| Publication Type: | Meta-Analysis; Systematic Review; Journal Article; Research Support, N.I.H., Extramural |
| Language: | English |
| Journal Info: | Publisher: Wolters Kluwer Health, Inc Country of Publication: United States NLM ID: 101695860 Publication Model: eCollection Cited Medium: Internet ISSN: 2471-254X (Electronic) Linking ISSN: 2471254X NLM ISO Abbreviation: Hepatol Commun Subsets: MEDLINE |
| Imprint Name(s): | Publication: 2023- : [Philadelphia] : Wolters Kluwer Health, Inc.; Original Publication: [Hoboken, NJ] : Wiley Periodicals, Inc. on behalf of the American Association for the Study of Liver Diseases, [2017]- |
| MeSH Terms: | Carcinoma, Hepatocellular* ; Liver Neoplasms*; Humans |
| 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.; (Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American Association for the Study of Liver Diseases.) |
| References: | PLoS One. 2019 Jan 14;14(1):e0210730. (PMID: 30640924); Clin Gastroenterol Hepatol. 2023 Apr;21(4):1094-1096.e2. (PMID: 34965448); J Surg Oncol. 2017 Mar;115(3):330-336. (PMID: 27813094); Clin Gastroenterol Hepatol. 2023 Jul;21(8):2135-2149. (PMID: 36813012); J Hepatol. 2021 May;74(5):1212-1224. (PMID: 33545267); Curr Oncol. 2013 Apr;20(2):e123-31. (PMID: 23559879); HPB (Oxford). 2017 Feb;19(2):133-139. (PMID: 27916436); Hepatology. 2021 Feb;73(2):713-725. (PMID: 32383272); Cancer. 2018 Feb 15;124(4):743-751. (PMID: 29072773); Ann Surg Oncol. 2014 Apr;21(4):1287-95. (PMID: 24318095); Control Clin Trials. 1986 Sep;7(3):177-88. (PMID: 3802833); J Multidiscip Healthc. 2018 Jan 19;11:49-61. (PMID: 29403284); Oncologist. 2020 May;25(5):431-437. (PMID: 31876321); J Surg Oncol. 2014 Oct;110(5):494-9. (PMID: 24986235); Radiology. 2018 Dec;289(3):816-830. (PMID: 30251931); Am J Gastroenterol. 2016 Jul;111(7):967-75. (PMID: 27166130); Clin Gastroenterol Hepatol. 2022 Jan;20(1):9-18. (PMID: 32961340); Cell Metab. 2022 Jul 5;34(7):969-977.e2. (PMID: 35793659); Am J Clin Oncol. 2015 Dec;38(6):557-63. (PMID: 24064759); J Hepatol. 2020 Feb;72(2):250-261. (PMID: 31954490); J Natl Compr Canc Netw. 2021 May 28;19(9):1063-1071. (PMID: 34077908); Biometrics. 1994 Dec;50(4):1088-101. (PMID: 7786990); BMJ. 2021 Mar 29;372:n71. (PMID: 33782057); Cancer Manag Res. 2020 Sep 30;12:9363-9374. (PMID: 33061625); Hepatology. 2022 May;75(5):1289-1299. (PMID: 34778999); Gastroenterology. 2017 Jun;152(8):1954-1964. (PMID: 28283421); HPB (Oxford). 2008;10(6):405-11. (PMID: 19088925); Semin Liver Dis. 2021 Jan;41(1):1-8. (PMID: 33764480); Ann Surg Oncol. 2011 Aug;18(8):2116-25. (PMID: 21442345); J Clin Gastroenterol. 2017 Oct;51(9):845-849. (PMID: 28877082); J Clin Med. 2020 Jul 30;9(8):. (PMID: 32751451); Br J Cancer. 2013 Oct 29;109(9):2295-300. (PMID: 24084764); J Natl Compr Canc Netw. 2016 Jan;14(1):38-46. (PMID: 26733553); BMJ. 2011 Aug 08;343:d2090. (PMID: 21824904); Cancer Res. 2014 Jun 1;74(11):2913-21. (PMID: 24840647); Int J Breast Cancer. 2011;2011:831605. (PMID: 22295234); Clin Gastroenterol Hepatol. 2022 Dec;20(12):2818-2825.e1. (PMID: 34902568); J Hepatol. 2022 Mar;76(3):681-693. (PMID: 34801630); BMJ. 1997 Sep 13;315(7109):629-34. (PMID: 9310563); Hepatology. 2023 Dec 1;78(6):1922-1965. (PMID: 37199193); HPB (Oxford). 2014 Nov;16(11):1009-15. (PMID: 24888730); J Surg Oncol. 2019 Dec;120(8):1365-1370. (PMID: 31642056); Abdom Radiol (NY). 2020 Jan;45(1):177-187. (PMID: 31342103); Nat Rev Dis Primers. 2021 Jan 21;7(1):6. (PMID: 33479224); J Natl Med Assoc. 2020 Jun;112(3):268-274. (PMID: 32291070) |
| Grant Information: | R01 CA256977 United States CA NCI NIH HHS; R01 MD012565 United States MD NIMHD NIH HHS; U01 CA271888 United States CA NCI NIH HHS |
| Entry Date(s): | Date Created: 20230427 Date Completed: 20230501 Latest Revision: 20240917 |
| Update Code: | 20260130 |
| PubMed Central ID: | PMC10146543 |
| DOI: | 10.1097/HC9.0000000000000143 |
| PMID: | 37102768 |
| Database: | MEDLINE |
Meta-Analysis; Systematic Review; Journal Article; Research Support, N.I.H., Extramural