Page 220 - ebook HCC

GENEVA, SWITZERLANDA, SWITZERLAND
PROGRAMME AND ABSTRACTSAND ABSTRACTS
EASL HCC SUMMITHCC SUMMIT
218 PROGRAMME GENEV EASL 219
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FEBRUARY 13 - 16, 2014Y 13 - 16, 2014
FEBRUAR
Poster Board Number C14 Poster Board Number C15
THE INDIAN NATIONAL ASSOCIATION FOR PERCUTANEOUS LOCAL INJECTION OF
STUDY OF THE LIVER (INASL) CONSENSUS ON ETHANOL AND MITOXANTRONE IN TREATMENT
PREVENTION, DIAGNOSIS AND MANAGEMENT OF HEPATOCELLULAR CARCINOMA
OF HEPATOCELLULAR CARCINOMA IN INDIA
Ahmed Bihery , Mostafa El-Shamy , Talaat El-Mokadem , Tarik Zaher ,
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Walid Abd El Dayem , Talaat Fathy , Mohamed Emara 1
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Ashish Kumar on behalf of The INASL Task-Force on Hepatocellular Carcinoma 1 Tropical Medicine, Clinical Oncology, Faculty of Medicine, Zagazig University,
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1 Gastroenterology & Hepatology, Sir Ganga Ram Hospital, New Delhi, India Zagazig, Egypt
Corresponding author’s e-mail: ashishk10@yahoo.com Corresponding author’s e-mail: ahmedbuhery@yahoo.com
Introduction: Hepatocellular carcinoma (HCC) is one of the major causes of morbidity, Introduction: New therapeutic choices have been developed for hepatocellular carcinoma
mortality and healthcare expenditure in patients with chronic liver disease. There are no (HCC), including percutaneous ablation therapy, transarterial chemoembolization,
consensus guidelines on diagnosis and management of HCC in India. radiation therapy and molecular target therapy. Ablation of liver tumors is currently the
main alternative to formal liver resection.
Results: The Indian National Association for Study of the Liver (INASL) set up a Task-
Force on HCC in 2011, with a mandate to develop consensus guidelines for diagnosis Aims: This work aimed at comparing percutaneous ethanol injection (PEI) with combined
and management of HCC, relevant to disease patterns and clinical practices in India. percutaneous ethanol and mitoxantrone injection (PIM) in treatment of HCC. This study
The Task-Force first identified various contentious issues on various aspects of HCC and included 125 patients with 131 HCC lesions which were randomly divided into two groups;
these issues were allotted to individual members of the Task-Force who reviewed them group I composed of 68 lesions in 65 patients treated with PEI. Group II composed of 63
in detail. The Task-Force used the Oxford Center for Evidence Based Medicine – Levels lesions in 60 patients treated with PEI and PIM. Clinical assessment, laboratory evaluation
of Evidence of 2009 for developing an evidence-based approach. A 2-day round table and CT studies were performed to all patients pre treatment and at 3, 6, and 12 months
discussion was held on 9 and 10 February, 2013 at Puri, Odisha, to discuss, debate, post treatment. Each focal lesion was considered as one subject.
th
th
and finalize the consensus statements. The members of the Task-Force reviewed and
discussed the existing literature at this meeting and formulated the INASL consensus Results: The percentage of ablation in both groups at 3, 6, 12 months were 60.3%, 48.5%
CLINICAL POSTER ABSTRACTS Conclusions: These are the first clinical practice guidelines generated by INASL on the number of local recurrence in group I compared to group II. Side effects and complications CLINICAL POSTER ABSTRACTS
statements for each of the issues. These guidelines will be published in the official journal
and 39.7% in group I respectively versus 85.5%, 74.6% and 68% in group II respectively
of INASL.
with a statistical significant difference between the two groups. There is an increased
are comparable in both groups.
diagnosis and management of HCC in India. These guidelines are evidence based and
Conclusions: Combination of PEI and PIM is better than PEI alone without additional
are aimed at providing the best possible care to the patients of HCC in India according
to the current evidence. They will also ensure a uniformity of diagnostic and treatment
approaches of HCC in the entire country and will also serve as framework for future
alone.
research on HCC in India. complication and recurrence rate seemed to be better in combination therapy than PEI