Discrepancies in Management of Hepatocellualr Carcinoma Between Practice and Recommendations

• Conditions: Hepatocellular Carcinoma

• Registration Number: NCT04189809
• Lead Sponsor: University Hospital, Montpellier

Brief Summary

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.

Detailed Description

Not available

Study Timeline

• Study Start: 2019-11-30
• Study First Submitted: 2019-12-04
• Study First Submitted QC: 2019-12-04
• Study First Posted: 2019-12-06
• Status Verified: 2020-03
• Primary Completion: 2020-03-01
• Last Update Submitted: 2020-03-09
• Last Update Posted: 2020-03-10
• Study Completion: 2020-12-25

Recruitment & Eligibility

• Status: UNKNOWN
• Sex: All
• Target Recruitment: 1000

Inclusion Criteria

Not provided

Exclusion Criteria

Not provided

Study & Design

• Study Type: OBSERVATIONAL
• Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
Rate of therapeutic proposals correctly predicted by the BCLC international classification	1 day	Rate of therapeutic proposals correctly predicted by the BCLC international classification

Secondary Outcome Measures

Name	Time	Method
Rates and causes of discrepancies	1 day	Rates and causes of discrepancies

Trial Locations

Locations (1)

Uhmontpellier; 🇫🇷 Montpellier, France