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Abstract
Background: Hepatocellular carcinoma (HCC) is the second leading cause of cancer related death worldwide as well as in Egypt. Due to the diversity of available treatment options and patients’ presentations, a multidisciplinary team should decide clinical management of HCC. Aim: This study was designed to evaluate the outcome of management of HCC patients and evaluate the impact of multidisciplinary approach on the outcome. Material and methods: This retrospective study was performed on all patients (924) with HCC who attended and sought medical advice in Kasr El-Ainy HCC clinic. Clinical, laboratory and imaging assessments were done. HCC was diagnosed and treated according to EASL and BCLC guidelines and then attended the follow up during the period from February 2009 to November 2014. Results: Almost all cases developed HCC on top of cirrhosis (99.7%) that was mainly due to HCV(86%). Most of our patients were Child-Pugh A (52.3%) or B (36.7%) and commonly presented with small single lesions. According to the BCLC guidelines, different lines of treatment were offered to the patients; curative treatment was provided to 223(24.1%) patients, palliative treatment was applied to 417(45.1%) patients, 87(9.4%) of patients had combined treatment while supportive symptomatic care was provided to the rest of the patients 197(21.3%). The overall median survival was 14.2 months which reach up to 26 months with curative treatment. Five variables were proved to be independent prognostic factors, these factors are serum bilirubin, albumin and AFP, size of the lesion and the application of specific treatment (curative and palliative). Concluson: Multidisciplinary management leads to rapid and definitive treatment decisions which leads to better prognosis and improved survival