Differences in the presentation and treatment of primary liver tumors at a hepatology center and an oncology center

K P Rojas-Pintor; M A Arizmendi-Villarreal; J E Aparicio-Salas; D P Moreno-Peña; D Hernández-Barajas; P Cordero-Pérez; L E Muñoz-Espinosa

doi:10.1016/j.rgmx.2020.08.005

Differences in the presentation and treatment of primary liver tumors at a hepatology center and an oncology center

Rev Gastroenterol Mex (Engl Ed). 2021 Mar 3:S0375-0906(21)00002-1. doi: 10.1016/j.rgmx.2020.08.005. Online ahead of print.

[Article in English, Spanish]

Authors

K P Rojas-Pintor¹, M A Arizmendi-Villarreal¹, J E Aparicio-Salas¹, D P Moreno-Peña¹, D Hernández-Barajas², P Cordero-Pérez¹, L E Muñoz-Espinosa³

Affiliations

¹ Centro de Hepatología, Medicina Interna, Hospital Universitario Dr. José Eleuterio González, Universidad Autónoma de Nuevo León, Monterrey, México.
² Centro Universitario Contra el Cáncer, Hospital Universitario Dr. José Eleuterio González, Universidad Autónoma de Nuevo León, Monterrey, México.
³ Centro de Hepatología, Medicina Interna, Hospital Universitario Dr. José Eleuterio González, Universidad Autónoma de Nuevo León, Monterrey, México. Electronic address: linda_uanl@hotmail.com.

PMID: 33676785
DOI: 10.1016/j.rgmx.2020.08.005

Abstract

Introduction and aims: Primary liver cancer is a public health problem in Mexico and the world. Liver transplantation (LT) is the ideal treatment for early hepatocellular carcinoma (HCC). Our aim was to evaluate the characteristics of patients with HCC and cholangiocarcinoma (CC) at two centers and identify transplantation candidates.

Materials and methods: A retrospective observational study was conducted at the Hepatology Center (HC) and the University Center Against Cancer (UCAC), within the time frame of 2012-2018. HCC or intrahepatic CC was confirmed in 109 patients. Staging classifications, transplant selection models, and a predictive model for post-LT recurrence were applied to the HCC patients.

Results: Of the total population, 93% (n = 102) presented with cirrhosis, 86% (n = 94) had HCC (HC: 58%, UCAC: 42%), and 14% (n = 15) had intrahepatic CC (HC: 40%, UCAC: 60%). Of the HC patients with HCC, Okuda I-II, BCLC A-B, and AFP levels < 100 ng/m predominated, whereas Okuda II-III, BCLC C-D, and AFP levels > 1,000 ng/mL predominated in the UCAC patients. Half of the HC population with HCC met the criteria for LT, in contrast to 23% of the UCAC patients. Fifteen patients were evaluated for LT, and at present, six have undergone transplantation.

Conclusions: The most frequent primary liver tumor was HCC. Patients from the HC presented with earlier-stage disease and a high number of them met the criteria for LT. Only patients from the HC underwent transplantation.

Keywords: Alfafetoproteína; Alpha-fetoprotein; Centro de Hepatología; Centro oncológico; Hepatology center; Neoplasia primaria de hígado; Oncology center; Primary liver tumor; Tratamiento; Treatment.