Hepatocellular Carcinoma Clinical Trial
Official title:
Management of Hepatocellular Carcinoma : Discrepancies Between BCLC Classification and Clinical Practice in a Large Regional Multicentric Cohort
The complex management of hepatocellular carcinoma has prompted many learned societies to
issue their management recommendations or decision-making algorithms to best assist in the
therapeutic decision-making of patients with HCC. Over time, the use of the BCLC algorithm
(for Barcelona Clinic Liver Cancer) has become essential, at least in the West, thanks to a
relatively simple and applicable classification system, and the clinical validation of
numerous studies. The BCLC algorithm thus relies on the general condition of the patient, the
CHILD-PUGH score reflecting hepatic function, and the tumor extension to propose one or more
therapeutic solutions according to the level of scientific evidence, associating with each
one. subgroups the expected survival.
While this BCLC classification has the merit of having the protocol for the management of
HCC, thus avoiding many drifts related to possible local preferences, it also has many
defects. For example, this classification is only rarely updated, which limits the
integration of innovative therapies. Then, its design and updates were supported by the
recommendations of a limited group of experts that is not necessarily representative of all
the key players present daily in the management of CHC. Finally, some studies have begun to
point out that this classification was interesting from a theoretical point of view, but that
in practice the diversity of complex situations meant that its care recommendations were not
applicable in a significant number of cases.
The objective of our study is to analyze the applicability of the BCLC classification in
real-life situations. To overcome possible "center effects", the investigators analyzed in an
exhaustive way the therapeutic decisions taken during the multi-disciplinary consultation
meetings of 2018 and 2019 at the level of a large French region, by relying on the regional
network of OncoOccitanie Oncology Record. In a second step, the investigators will analyze
the causes of the discrepancies to finally propose an improvement of this BCLC
classification.
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